The need for routine radionuclide bone scan as aprt of the preoperative metastatic work-up in patients with renal cell carcinoma has been debated by several investigators more than 10 years. To investigate the value of radionuclide bone scan,
radionuclide bone scans were performed preoperatively as part of staging procedures in 79 patients of 91 patients with renal cell carcinoma from 1989 to 1994. We analyzed the findings of bone scan according to the clinical and laboratory
variables.
When
hot uptake was detected on the preoperative bone scan, it was interpretated positive if there was no history of trauma or absence of bone and joint disease such as degenerative joint disease or arthritis. The bone scans were positive in 21 cases
(26.6%)
and negative in 58 cases (73.4%). The bone scans were neither correlated with the clinical variables such as incidentaloma, age of the patient, performance status, bone pain, the size of the tumor, T categry of the tumor, thrombosis of renal vein
or
IVC, lymph node metastasis and extraskeletal metastasis nor with laboratoty variables such as serum alkaline phophatase, hemoglobin, serum calcium and ESR. We also analyzed positive scan according to the number of bony lesions. There was no
correlation
between the number of lesions on bone scan and clinical and laboratory variables. In conclusion, there was no clinical and laboratory parameters predicting positivity of bone scan. This suggests that all patients with renal cell carcinoma should
be
staged routinely with preoperative bone scan as the part of the initial clinical work up.
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