title: Time to castration resistance is an independent predictor of castration-resistant prostate cancer survival.
abstract: OBJECTIVE
  Easily assessable clinical predictors of response to chemotherapy in advanced castration-resistant prostate cancer (CRPC) are few. The objective of this retrospective study was to search for and identify such candidate predictors of outcome.
  
  
  METHODS
  A retrospective analysis of clinical data of CRPC patients entered in the Clinical Therapeutics' departmental prostate cancer database from 1996-2009 was performed. Univariate and multivariate analyses for progression-free survival and overall survival included patients receiving both docetaxel- and non-docetaxel-containing regimens.
  
  
  RESULTS
  From 1996 until June 2009, 286 out of 313 patients in our database were treated with chemotherapy. Prostate-specific antigen (PSA) reduction >30% correlated with improved survival irrespective of treatment. Beyond previously reported predictors, i.e. baseline PSA >30 ng/dl, hemoglobin below 10 mg/dl, weight loss, poor performance status, elevated lactic dehydrogenase and alkaline phosphatase, and time to CRPC of less than or equal to two years was associated with a poor overall survival and shorter progression-free survival upon univariate analysis. Pain was associated with shorter survival. Multivariate analysis confirmed time to CRPC, lactate dehydrogenase and alkaline phosphatase as independent predictors of overall and progression-free survival.
  
  
  CONCLUSIONS
  Time to castration resistance is an important predictor of outcome in CRPC. PSA reduction >30% predicts survival improvement following chemotherapy for CRPC regardless of chemotherapy applied.
authors.affiliation: Department of Clinical Therapeutics, The University of Athens, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Bournakis
authors.forename: Eleni
authors.initials: E
authors.lastname: Efstathiou
authors.forename: Andreas
authors.initials: A
authors.lastname: Varkaris
authors.forename: Sijin
authors.initials: S
authors.lastname: Wen
authors.forename: Michael
authors.initials: M
authors.lastname: Chrisofos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Deliveliotis
authors.forename: Christos
authors.initials: C
authors.lastname: Alamanis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Anastasiou
authors.forename: Constantine
authors.initials: C
authors.lastname: Constantinides
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Bamias
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009376:Neoplasms, Hormone-Dependent / Q000401:mortality* / Q000628:therapy; D009919:Orchiectomy; D010146:Pain / Q000209:etiology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D000970:Antineoplastic Agents; D017430:Prostate-Specific Antigen