The Effect of Multiplicity of Metastatic Sites on Hormone Refractory Prostate Cancer

Background: This study retrospectively evaluated the prognostic factors and treatment outcome of patients with hormone-refractory prostate cancer who received chemotherapy. Methods: We reviewed records of hormone-refractory prostate cancer patients who received chemotherapy between December 2004 and May 2011 at the Clinical Oncology and Nuclear Medicine Department, Mansoura University and the Oncology Outpatient Clinic of East Delta Insurance Institute, Egypt with regards to patient characteristics, response to chemotherapy, toxicity, survival and prognostic factors. Results: A total of 37 records were analyzed. Patientsʹ median age was 66 years. The majority (70%) had bone metastases. One patient received single agent prednisolone and 2 received single agent vinorelbine. There were 34 (92%) who received a docetaxelbased chemotherapy regimen for whom we determined the treatment outcome and prognostic factors. Patients underwent a median of six cycles of treatment (range: 4–11). Fourteen of 34 patients (%41) had ?50% decrease in serum prostatic-surface antigen. Among 16 patients who had measurable disease at the baseline, 8 (50%) achieved a partial response according to radiographic criteria. Of the 25 patients who experienced cancer pain before treatment initiation, 15 (60%) reduced their analgesic drug intake. Grades 3-4 neutropenia occurred in 13 (38%) patients. The median follow-up period was 13 months and the median event-free survival was 7 months (range: 4-31). The median overall survival period was 12 months (range: 4.5-37). According to multivariate regression analysis, multiplicity of metastatic sites was the only independent prognostic factor (P=0.005). Conclusions: Hormone-refractory prostate cancer is not considered totally resistant to chemotherapy. In this study, multiplicity of metastatic sites is the only independent prognostic factor. Survival figures are not satisfactory, therefore additional research is needed for achieving a better treatment outcome.