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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVES, MATERIAL AND METHODS, RESULTS. Meshes: Aged, Biopsy, Bone Neoplasms, Follow-Up Studies, Humans, Male, Prostate, Prostate-Specific Antigen, Prostatectomy, Prostatic Neoplasms, Radionuclide Imaging, Time Factors.
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Does PSA of less than 20 ng/ml exclude the diagnosis of metastatic prostate cancer? Context: To demonstrate the considerable risk of bone metastases from clinically localized prostatic cancer with PSA greater than 20 ng/ml. Patients presenting an indication for radical prostatectomy (younger than 70, with localized prostate cancer, less than 6 out of 9 positive biopsies) and PSA less than 20 ng/ml (Tandem) were selected for this intent-to-treat study. Seven of the 210 patients corresponding to the selection criteria presented with bone metastases and 4 of them had a PSA less than 10 ng/ml. None had lymph node metastases.
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The risk of bone metastases despite PSA less than 20 ng/ml is therefore not negligible. In our opinion, it is necessary therefore to continue to include bone scan in the staging assessment of clinically localized prostate cancer.