Bone scintigraphy and tumor markers in the post-operative follow-up of breast, colorectal, prostate and renal cancer

Between Jan 1986 and Dec 1997, 323 breast, 94 colorectal, 36 renal and 17 prostate cancer patients were serially followed-up with CEA-TPA-CA15.3, CEA-TPA-GICA-CA72.4, GICA-TPA-ferritin associations and PSA respectively. All patients presenting bone scintigraphy (BS) with equivocal interpretation and concomitant constant elevation (CE) or progressive increase (PI) in one or more of tumor markers (TM) were selected for computed tomography (CT), except those with equivocal BS of ribs, who were evaluated by skeletal x-ray. In non relapsed patients affected by the different cancer types, concomitant dynamic TM evaluation allowed to decrease by 13% up to 48% the equivocal BS subjects to be studied further with CT or x-ray. Moreover TM selected for radiological investigation 81% to 100% of those with skeletal metastases and equivocal BS. These data point out the relevant role of TM in improving BS specificity and in selecting those who need further radiological examinations.