Prediction for survival following docetaxel-based chemotherapy in Taiwanese men with castration-resistant metastatic prostate cancer

Abstract

Introduction: Docetaxel-based chemotherapy has been demonstrated to improve survival in patients with metastatic castration-resistant prostate cancer (mCRPC). The aim of this study is to analyze the possible prognostic factors associated with survival and to attract physicians' attention to high-risk patients. Material and methods: Thirty-nine consecutive patients with mCRPC who received docetaxel-based chemotherapy between July 2007 and November 2013 were enrolled in this study. The Kaplan–Meier curve was used to assess the association between prostate-specific antigen (PSA) response (defined as PSA level decreases ≥ 50%), and overall survival and cancer-specific survival. Cox regression analysis was performed to identify the independent significant predictors of overall survival and cancer-specific survival. Results: Twenty-one of the 39 patients (54%) experienced PSA response and the median overall survival was 13.51 months (range, 3–43 months). Patients with PSA response had longer time to PSA nadir level compared with patients without PSA response (p = 0.010). PSA response was an independent factor of overall survival and cancer-specific survival from Cox regression analysis (p = 0.014 and p = 0.05, respectively). In both univariate and multivariate analysis, cycles of chemotherapy, time to PSA nadir, and time to PSA progression were significant predictors for overall survival. Conclusion: The present study showed that PSA response demonstrated significance as a predictor for clinical outcome. However, Charlson comorbidity index (CCI) is not related to survival. A further prospective analysis is warranted.

Keywords

• castration-resistant metastatic prostate cancer
• docetaxel