title: The oncological outcomes and risk stratification in docetaxel chemotherapy for castration-resistant prostate cancer.
abstract: OBJECTIVE
  To clarify the risk factors and develop a refined risk-stratification model to help in the appropriate selection of docetaxel chemotherapy in patients with castration-resistant prostate cancer.
  
  
  METHODS
  This study included 97 Japanese patients with castration-resistant prostate cancer who were treated with 70-75 mg/m(2) docetaxel and 10 mg prednisone every 3 or 4 weeks from 2008 to 2013. The oncological outcomes and prognostic significance of clinicopathological factors were analyzed, and significant prognostic factors were used to develop a risk-stratification model.
  
  
  RESULTS
  Prostate-specific antigen decline was observed in 75 patients (77.3%), including 43 (44.3%) who achieved a prostate-specific antigen decline of ≥ 50%. The median progression-free survival and overall survival were 5.1 and 20.8 months, respectively. Univariate analysis identified performance status, alkaline phosphatase value, visceral metastasis, duration from diagnosis, duration from initiation of hormone treatment and prior treatment with estramustine as significant predictors of overall survival. Among these, alkaline phosphatase value, visceral metastasis and duration from initiation of hormone treatment were independent prognostic factors in multivariate analysis. Furthermore, risk classification according to the number of independent risk factors present effectively stratified survival among docetaxel-treated castration-resistant prostate cancer patients.
  
  
  CONCLUSIONS
  Oncologic outcomes in Japanese patients with castration-resistant prostate cancer receiving docetaxel chemotherapy were comparable to or slightly better than those in Western populations, and the risk-stratification model developed in this study may help to predict prognosis and contribute to the selection of suitable therapy after castration resistance.
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Masaki
authors.initials: M
authors.lastname: Shiota
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka yokoa@uro.med.kyushu-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Yokomizo
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Takumi
authors.initials: T
authors.lastname: Adachi
authors.affiliation: Division of Urology, Harasanshin Hospital, Fukuoka, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Koga
authors.affiliation: Division of Urology, Harasanshin Hospital, Fukuoka, Japan.
authors.forename: Akito
authors.initials: A
authors.lastname: Yamaguchi
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Imada
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Ario
authors.initials: A
authors.lastname: Takeuchi
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Keijiro
authors.initials: K
authors.lastname: Kiyoshima
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Junichi
authors.initials: J
authors.lastname: Inokuchi
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Tatsugami
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
authors.forename: Seiji
authors.initials: S
authors.lastname: Naito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D018572:Disease-Free Survival; D000077143:Docetaxel; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000188:drug therapy; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy*; D018570:Risk Assessment; D012307:Risk Factors; D043823:Taxoids / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D043823:Taxoids; D000077143:Docetaxel; D017430:Prostate-Specific Antigen
keywords: castration-resistant prostate cancer; docetaxel; prostate cancer; risk factor