Hiwase MD, Jay A, Bulamu N, Teh J, Paterson F, Kichenadasse G, Vincent AD, O'Callaghan M; South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC). Evaluation of selective bone scan staging in prostate cancer - external validation of current strategies and decision-curve analysis. Prostate Cancer Prostatic Dis. 2022 Mar 14. doi: 10.1038/s41391-022-00515-8.

Contact: Andrew Vincent

Recommendations for staging newly diagnosed prostate cancer patients vary between guidelines and literature.

Our objective in this study was to validate and compare prediction models selecting newly diagnosed prostate cancer patients for bone scan staging. To achieve this, we validated eleven models in a population-based cohort of 10,721 patients diagnosed with prostate cancer between 2005 and 2019.

We identified three selective staging strategies that outperformed all other approaches but did so over different ranges of conservatism and tolerance. Scanning only EAU high-risk patients provided the greatest net-benefit over the greatest range of preference ratios and scenarios, but other options may be preferable depending upon the local healthcare system's degree of conservatism and tolerance.