<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background.</bold> Men 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.<bold>Methods.</bold> Men 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.<bold>Results.</bold> Two 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).<bold>Conclusions.</bold> Men with mCRPC, who have comorbidities may benefit from treatment with docetaxel.</abstract>

Background. Men 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.Methods. Men 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.Results. Two 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).Conclusions. Men with mCRPC, who have comorbidities may benefit from treatment with docetaxel.

Impact of comorbidity on the outcome in men with advanced prostate cancer treated with docetaxel

Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia

Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada

Medical Oncology Department and Translational Research Unit, Albacete University Hospital, Spain

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background. Men with metastatic castrate-resistant prostate cancer (mCRPC) may not receive docetaxel in everyday clinical practice due to comorbidities. Here...

Impact of comorbidity on the outcome in men with advanced prostate cancer treated with docetaxel

Published Online: Nov 27, 2015

Page range: 402 - 408

Received: May 05, 2015

Accepted: Jul 19, 2015

DOI: https://doi.org/10.1515/raon-2015-0038

Keywords
metastatic castration-resistant prostate cancer, comorbidity, chemotherapy

© 2015 Andrej Zist et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Impact of comorbidity on the outcome in men with advanced prostate cancer treated with docetaxel

Published Online: Nov 27, 2015

Page range: 402 - 408

Received: May 05, 2015

Accepted: Jul 19, 2015

DOI: https://doi.org/10.1515/raon-2015-0038

Keywordsmetastatic castration-resistant prostate cancer, comorbidity, chemotherapy

© 2015 Andrej Zist et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
metastatic castration-resistant prostate cancer, comorbidity, chemotherapy