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Development of a prognostic model for survival time prediction in castration-resistant prostate cancer patients.
Stangl-Kremser, Judith; Mari, Andrea; Suarez-Ibarrola, Rodrigo; D'Andrea, David; Korn, Stephan M; Pones, Mario; Kramer, Gero; Karakiewicz, Pierre; Enikeev, Dimitri V; Glybochko, Petri V; Briganti, Alberto; Shariat, Shahrokh F.
Afiliação
  • Stangl-Kremser J; Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
  • Mari A; Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.
  • Suarez-Ibarrola R; Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
  • D'Andrea D; Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
  • Korn SM; Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
  • Pones M; Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
  • Kramer G; Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
  • Karakiewicz P; Department of Surgery, University of Montreal, Montreal, Canada.
  • Enikeev DV; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
  • Glybochko PV; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
  • Briganti A; Department of Urology and Division of Experimental Oncology, URI, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Shariat SF; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Ru
Urol Oncol ; 38(6): 600.e9-600.e15, 2020 06.
Article em En | MEDLINE | ID: mdl-31953003
ABSTRACT

BACKGROUND:

To identify predictors of survival in patients treated with docetaxel chemotherapy for castration-resistant prostate cancer (CRPC).

METHODS:

We retrospectively analyzed clinical data from 186 patients who underwent docetaxel chemotherapy for CRPC from 2005 to 2016 at a single center. Pretreatment baseline variables including demographic and clinicopathological data were reviewed. Disease progression was defined by imaging and/or consecutive prostate-specific antigen (PSA) elevation. The systemic immune-inflammation index (SII), the modified Glasgow Prognostic Score (mGPS), and the neutrophil-lymphocyte ratio (NLR) were calculated. Univariable and multivariable Cox proportional hazards regression analyses reporting hazard ratios assessed the risk for disease progression and overall survival (OS). A survival nomogram was constructed.

RESULTS:

Most patients (n = 139, 74.7%) completed at least 6 cycles of docetaxel chemotherapy. 156 patients (82.9%) experienced disease progression during the studied period. Only mGPS was independently associated with disease progression in a multivariable model (P < 0.01). During the studied period, 98 patients (52.1%) died. The built survival nomogram included statistically significant variables for OS in univariable

analysis:

hemoglobin, PSA, alkaline phosphatase (AP), lactate dehydrogenase, SII, neutrophil-lymphocyte ratio, mGPS, and site of metastases; and had a concordance index of 0.703. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of above 40%. In multivariable analysis, only AP (P = 0.02), hemoglobin and PSA (P < 0.01, respectively) remained associated with OS.

CONCLUSIONS:

PSA, AP, and hemoglobin are independent prognosticators for OS. Although mGPS is a promising marker for tumor progression and SII is a plausible prognostic marker for OS, valid integration of inflammatory indices into a prognostic model requires validation studies. Predictive and prognostic biomarkers are desperately needed to guide physicians in treatment counseling given the heterogeneous nature of CRPC and the plethora of effective therapies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias de Próstata Resistentes à Castração / Docetaxel / Antineoplásicos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Urol Oncol Assunto da revista: NEOPLASIAS / UROLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Áustria

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias de Próstata Resistentes à Castração / Docetaxel / Antineoplásicos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Urol Oncol Assunto da revista: NEOPLASIAS / UROLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Áustria