Which Factors Predict Overall Survival in Patients With Metastatic Castration-Resistant Prostate Cancer Treated With Abiraterone Acetate Post-Docetaxel?
التفاصيل البيبلوغرافية
العنوان:
Which Factors Predict Overall Survival in Patients With Metastatic Castration-Resistant Prostate Cancer Treated With Abiraterone Acetate Post-Docetaxel?
Individual patients' survival varies greatly in metastatic castration-resistant prostate cancer. Retrospective analysis of 368 patients treated with docetaxel and starting abiraterone acetate revealed 5 adverse prognostic factors: hemoglobin < 12 g/dL, > 10 metastases, ECOG performance status >= 2, radiographic progression, and time since diagnosis < 90 months. A prognostic model stratifies patients into 3 groups with different estimated survival, which can aid in patient counseling.Abiraterone acetate (AA) increases overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel. However, survival time varies substantially between individuals. Our goal was to identify prognostic factors that better estimate OS. Materials and Methods: This is a retrospective multicentric analysis of 368 patients with mCRPC starting AA with prednisone after docetaxel. Cox proportional hazards statistics were applied. A multivariate model was constructed based on significant univariate predictors by using a manual stepwise forward and backward selection strategy. Model performance was determined by using receiver operating characteristic (ROC) curves. Results: Univariate analysis identified 20 significant OS predictors. A multivariate model was constructed, based on 220 patients, incorporating 5 independent risk factors for decreased OS at the time of AA initiation: hemoglobin 10 metastases (HR 1.80), ECOG performance status >= 2 (HR 1.88), radiographic progression (HR 1.50), and time since diagnosis < 90 months (HR 1.66, all P