Prognostic factors for overall survival in castration-resistant metastatic prostate cancer treated with docetaxel (MeProCSS): results from a German real-world cohort
- 27.01.2025
- Urology – Original Paper
Erschienen in:
- Verfasst von
- Felix Steffens
- Frederik Wessels
- Svetlana Hetjens
- Nicolas Carl
- Katja Nitschke
- Daniel Uysal
- Nadim Moharam
- Paul Patroi
- Thomas Stefan Worst
- Karl Friedrich Kowalewski
- Maurice Stephan Michel
- Manuel Neuberger
- Erschienen in
- International Urology and Nephrology | Ausgabe 7/2025
Abstract
Purpose
To identify prognostic factors for overall survival (OS) and develop a prognostic score in patients receiving docetaxel in metastatic castration-resistant prostate cancer (mCRPC).
Methods
Retrospective analysis was conducted on mCRPC patients treated with docetaxel at a German tertiary center between March 2010 and November 2023. Prognostic clinical and laboratory factors were analyzed using uni- and multivariable logistic regression. Next, the result of the modified Glasgow Prognostic Score (mGPS), neutrophil-to-lymphocyte ratio (NLR) (cut-off ≥3), the presence of high-volume bone metastases (as defined by CHAARTED criteria), hemoglobin (Hb) (cut off < 13.2 g/dl), Gleason score ≥8, and presence of visceral metastases were combined into the Metastasized Prostate Cancer Survival Score (MeProCSS). Patients were then stratified into three prognostic groups. Their OS was assessed by Kaplan–Meier analysis.
Results
Median OS for the overall cohort (n = 153) and the first-line cohort (n = 83) was 18 and 21.5 months, respectively. In multivariable analysis, high-volume bone metastases and Hb levels below the norm were significant predictors of shorter OS in the total cohort. The MeProCSS demonstrated an area under curve (AUC) of 0.837 in the overall cohort and 0.946 in first-line cohort. Kaplan–Meier analysis revealed a significant association between lower MeProCSS and longer OS in both the overall (p<0.001) and first-line (p = 0.035) cohort.
Conclusion
MeProCSS, consisting of routinely collected parameters prior to the start of chemotherapy, seems to effectively stratify patients with mCRPC into risk groups based on their metastatic burden, nutritional and inflammatory status. This model may guide treatment decisions and reveal a potentially often underestimated or overlooked urgency for additional measures as supportive palliative care in mCRPC patients. Further large and prospective studies are necessary for validation of MeProCSS—also in other systemic PC therapy regimens.
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- Titel
- Prognostic factors for overall survival in castration-resistant metastatic prostate cancer treated with docetaxel (MeProCSS): results from a German real-world cohort
- Verfasst von
-
Felix Steffens
Frederik Wessels
Svetlana Hetjens
Nicolas Carl
Katja Nitschke
Daniel Uysal
Nadim Moharam
Paul Patroi
Thomas Stefan Worst
Karl Friedrich Kowalewski
Maurice Stephan Michel
Manuel Neuberger
- Publikationsdatum
- 27.01.2025
- Verlag
- Springer Netherlands
- Erschienen in
-
International Urology and Nephrology / Ausgabe 7/2025
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584 - DOI
- https://doi.org/10.1007/s11255-025-04389-2
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