Impact of comorbidity on the outcome in men with advanced prostate cancer treated with docetaxel |
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Authors: | Andrej Zist Eitan Amir Alberto F Ocana Bostjan Seruga |
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Institution: | 1.Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia;2.Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada;3.Medical Oncology Department and Translational Research Unit, Albacete University Hospital, Spain |
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Abstract: | BackgroundMen with metastatic castrate-resistant prostate cancer (mCRPC) may not receive docetaxel in everyday clinical practice due to comorbidities. Here we explore the impact of comorbidity on outcome in men with mCRPC treated with docetaxel in a population-based outcome study.MethodsMen with mCRPC treated with docetaxel at the Institute of Oncology Ljubljana between 2005 and 2012 were eligible. Comorbidity was assessed by the age-adjusted Charlson comorbidity index (aa-CCI) and adult comorbidity evaluation (ACE-27) index. Hospital admissions due to the toxicity and deaths during treatment with docetaxel were used as a measure of tolerability. Association between comorbidity and overall survival (OS) was tested using the Cox proportional hazards analysis.ResultsTwo hundred and eight men were treated with docetaxel. No, mild, moderate and severe comorbidity was present in 2%, 32%, 53% and 13% using aa-CCI and in 27%, 35%, 29% and 8% when assessed by ACE-27. A substantial dose reduction of docetaxel occurred more often in men with moderate or severe comorbidity as compared to those with no or mild comorbidity. At all comorbidity levels about one-third of men required hospitalization or died during treatment with docetaxel. In univariate analysis a higher level of comorbidity was not associated with worse OS (aa-CCI HR 0.99; 95% CI 0.87–1.13], p = 0.93; ACE-27: HR 0.96; 95% CI 0.79–1.17], p = 0.69).ConclusionsMen with mCRPC, who have comorbidities may benefit from treatment with docetaxel. |
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Keywords: | metastatic castration-resistant prostate cancer comorbidity chemotherapy |
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