title: Prognostic factors and risk stratification in patients with castration-resistant prostate cancer receiving docetaxel-based chemotherapy.
abstract: BACKGROUND
  While novel drugs have been developed, docetaxel remains one of the standard initial systemic therapies for castration-resistant prostate cancer (CRPC) patients. Despite the excellent anti-tumor effect of docetaxel, its severe adverse effects sometimes distress patients. Therefore, it would be very helpful to predict the efficacy of docetaxel before treatment. The aims of this study were to evaluate the potential value of patient characteristics in predicting overall survival (OS) and to develop a risk classification for CRPC patients treated with docetaxel-based chemotherapy.
  
  
  METHODS
  This study included 79 patients with CRPC treated with docetaxel. The variables, including patient characteristics at diagnosis and at the start of chemotherapy, were retrospectively collected. Prognostic factors predicting OS were analyzed using the Cox proportional hazard model. Risk stratification for overall survival was determined based on the results of multivariate analysis.
  
  
  RESULTS
  PSA response ≥50 % was observed in 55 (69.6 %) of all patients, and the median OS was 22.5 months. The multivariate analysis showed that age, serum PSA level at the start of chemotherapy, and Hb were independent prognostic factors for OS. In addition, ECOG performance status (PS) and the CRP-to-albumin ratio were not significant but were considered possible predictors for OS. Risk stratification according to the number of these risk factors could effectively stratify CRPC patients treated with docetaxel in terms of OS.
  
  
  CONCLUSIONS
  Age, serum PSA level at the start of chemotherapy, and Hb were identified as independent prognostic factors of OS. ECOG PS and the CRP-to-albumin ratio were not significant, but were considered possible predictors for OS in Japanese CRPC patients treated with docetaxel. Risk stratification based on these factors could be helpful for estimating overall survival.
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan. keito608@wakayama-med.ac.jp.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kohjimoto
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Iguchi
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koike
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kusumoto
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Iba
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Kikkawa
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Nagahide
authors.initials: N
authors.lastname: Matsumura
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000556:secondary; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D002097:C-Reactive Protein / Q000378:metabolism; D004164:Diphosphonates / Q000627:therapeutic use; D000077143:Docetaxel; D006801:Humans; D007610:Kallikreins / Q000097:blood; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012709:Serum Albumin; D015996:Survival Rate; D043823:Taxoids / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D012709:Serum Albumin; D043823:Taxoids; D000077143:Docetaxel; D002097:C-Reactive Protein; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Castration-resistant prostate cancer; Docetaxel; Prognostic factor