MP87-02 PROGNOSTIC VALUE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO AND ESTABLISHMENT OF NOVEL RISK STRATIFICATION MODEL IN CASTRATION-RESISTANT PROSTATE CANCER PATIENTS TREATED WITH DOCETAXEL CHEMOTHERAPY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced III1 Apr 2015MP87-02 PROGNOSTIC VALUE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO AND ESTABLISHMENT OF NOVEL RISK STRATIFICATION MODEL IN CASTRATION-RESISTANT PROSTATE CANCER PATIENTS TREATED WITH DOCETAXEL CHEMOTHERAPY Yoshihiro Nakagami, Jun Nakashima, Yoshio Ohno, Ohori Makoto, and Masaaki Tachibana Yoshihiro NakagamiYoshihiro Nakagami More articles by this author , Jun NakashimaJun Nakashima More articles by this author , Yoshio OhnoYoshio Ohno More articles by this author , Ohori MakotoOhori Makoto More articles by this author , and Masaaki TachibanaMasaaki Tachibana More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1947AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Docetaxel (DTX) therapy is the standard treatment for castration-resistant prostate cancer (CRPC). The present study was undertaken to investigate independent prognostic factors and develop a stratification model of survival in CRPC patients treated with DTX therapy. METHODS The present study included 101 CRPC patients treated with DTX therapy from December 2003 to October 2013 in a single institution. We used the combination of docetaxel (DTX), estramustine phosphate (EMP) and hydrocortisone every 3 weeks. Associations of clinical factors with survival were analyzed using univariate and multivariate analyses. RESULTS The average number of treatment courses was 11. Median overall survival (OS) time was 21 months. In univariate analyses, patients with pain, impaired performance status, hemoglobin (Hb) ≤ 11 mg/dl, neutrophil-to-lymphocyte ratio (NLR) ≥ 2.6, lactate dehydrogenase ≥ 230 IU/L, PSA (at the initiation of DTX therapy) ≥ 110 ng/ml, alkaline phosphatase ≥ 650 IU/L and C-reactive protein (CRP) ≥ 2 mg/dl showed significantly lower survival rates than their respective counterparts. On the other hand, bone metastasis, age, PSA doubling time and lymph node metastasis were not significantly associated with OS. Multivariate analysis showed that presence of pain (hazard ratio [HR] 3.60, p < 0.001), CRP ≥ 2 mg/dl (HR 3.49, p = 0.002), impaired performance status (HR 2.75, p = 0.004), Hb ≤ 11 mg/dl (HR 1.93, p = 0.021), and NLR ≥ 2.6 (HR 1.98, p = 0.031) were independent predictors of OS. Using these 5 statistically significant variables, patients were stratified into 3 risk groups: low (HR = 1 – 3.60), intermediate (HR = 3.82 – 34.55), and high (HR = 34.68 – 132.03). The differences among the three groups were statistically significant CONCLUSIONS Elevation of NLR was an independent prognostic factor as were presence of pain, elevated CRP, impaired performance status and low Hb and the combination of these factors can stratify OS risks in CRPC patients treated with DXT therapy. Our risk stratification model may be useful to identify patients with poor prognosis, who might be good candidates for innovative treatment. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1084 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yoshihiro Nakagami More articles by this author Jun Nakashima More articles by this author Yoshio Ohno More articles by this author Ohori Makoto More articles by this author Masaaki Tachibana More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...