Pattern and Distribution of Skeletal Metastases in Patients With Prostate Cancer in Ghana: A Descriptive Analysis and a Model-Based Digital Nomogram for Oligo-Ostotic Versus Polyostotic Metastases.

Clustered bivariate analysis ALP elevation is the dominant discriminator of metastatic-burden quartiles; higher categories (≥ 122 U/L and especially ≥ 222 U/L) are markedly over-represented in Q2 and Q3, with highly significant likelihood-ratio (LR) tests (p < 0.0001).

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PSA, DRE, ISUP, and D’Amico remain heavily skewed toward high-risk strata across all quartiles; consequently, their additional explanatory power is limited, though ISUP shows a weak trend.

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