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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2016

01-11-2016 | Urologic Oncology

High Absolute Monocyte Count Predicts Poor Clinical Outcome in Patients with Castration-Resistant Prostate Cancer Treated with Docetaxel Chemotherapy

Authors: Keisuke Shigeta, MD, Takeo Kosaka, MD, PhD, Shigehisa Kitano, MD, PhD, Yota Yasumizu, MD, Yasumasa Miyazaki, MD, Ryuichi Mizuno, MD, PhD, Toshiaki Shinojima, MD, PhD, Eiji Kikuchi, MD, PhD, Akira Miyajima, MD, PhD, Hitoshi Tanoguchi, MD, PhD, Shintaro Hasegawa, MD, PhD, Mototsugu Oya, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2016

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Abstract

Background

The association of peripheral monocyte count and prostate cancer progression is not well characterized.

Objective

Our aim was to investigate the prognostic value of absolute monocyte count (AMC), which is thought to modulate immune response in the tumor microenvironment, in castration-resistant prostate cancer (CRPC) patients treated with docetaxel chemotherapy.

Methods

We retrospectively reviewed the medical records of 214 CRPC patients who received docetaxel therapy and were used as the training and validation set. Docetaxel at a dose of 75 mg/m2 was administered every 3 or 4 weeks. Clinicopathological factors and laboratory data were collected to assess the prognostic factors for overall survival (OS) and progression-free survival (PFS).

Results

In the training set, the median age was 73.0 years, and the median prostate-specific antigen (PSA) value was 31.7 ng/ml at initial treatment. The median OS and PFS were 23.0 months (range 1.20–84.0) and 11.2 months (range 3.6–78.0), respectively. According to multivariable Cox regression analysis, AMC ≥400/uL, PSA level ≥20 ng/ml, and Hb <10 mg/dL were associated with increased risk of PSA progression [hazard ratio (HR) 2.06, p = 0.005; HR 2.39, p = 0.002; and HR 2.38, p = 0.024, respectively]. Moreover, multivariate analysis for OS indicated that AMC ≥400/uL, pretreatment PSA level ≥20 ng/ml, presence of visceral metastasis, and alkaline phosphatase ≥284 U/L were independent prognostic factors for shortened OS (HR 2.07, p = 0.004; HR 2.18, p = 0.007; HR 2.11, p = 0.011; and HR 1.67, p = 0.048, respectively). According to the validation set, high AMC remained an independent prognostic factor for PFS and OS (HR 2.26, p = 0.001; and HR 3.10, p < 0.001, respectively).

Conclusions

Elevated monocyte counts were associated with aggressive tumor features and poor survival outcomes of patients with CRPC treated with docetaxel chemotherapy.
Appendix
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Metadata
Title
High Absolute Monocyte Count Predicts Poor Clinical Outcome in Patients with Castration-Resistant Prostate Cancer Treated with Docetaxel Chemotherapy
Authors
Keisuke Shigeta, MD
Takeo Kosaka, MD, PhD
Shigehisa Kitano, MD, PhD
Yota Yasumizu, MD
Yasumasa Miyazaki, MD
Ryuichi Mizuno, MD, PhD
Toshiaki Shinojima, MD, PhD
Eiji Kikuchi, MD, PhD
Akira Miyajima, MD, PhD
Hitoshi Tanoguchi, MD, PhD
Shintaro Hasegawa, MD, PhD
Mototsugu Oya, MD, PhD
Publication date
01-11-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 12/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5354-5

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