The prognostic significance of skeletal scintigraphy has been reassessed in relation to other tests by extended follow-up of 220 @entity1 . Skeletal metastases increased in prevalence with T stage and were associated with shorter survival irrespective of age. Early disease, a normal acid or alkaline phosphatase at presentation and well differentiated @entity5 were associated with longer survival. Alkaline phosphatase alone accounted for all of the differences in survival. Scintigraphic change preceded elevation of the prostatic acid phosphatase in 81% of the @entity1 whose initial scintigraphy and prostatic acid phosphatase were normal but who developed evidence of distant metastases on follow-up. The mean interval between scintigraphic conversion and the development of overt symptoms was 5.8 months. Our findings discount the value of skeletal scintigraphy for determining prognosis but do indicate that it is more sensitive than the acid phosphatase in identifying @entity1 before they become symptomatic. Scintigraphy is indicated as a routine staging procedure in all new @entity1 with @entity263 . In @entity1 with a normal alkaline phosphatase, a baseline and regular follow-up are needed to identify @entity1 likely soon to develop symptoms. If the alkaline phosphatase is elevated at presentation, scintigraphy is necessary to distinguish benign from malignant causes and to determine the extent of skeletal involvement.

Prognostic significance of alkaline and acid phosphatase and skeletal scintigraphy in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity263 :: ('MESH:D011471', 'Disease') :: ['carcinoma of prostate'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumours']
@entity263 :: (MESH:D011471,Disease) :: ['carcinoma of the prostate']
