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

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Acknowledgment

This work was supported in part by a Grant-in-Aid for Young Scientists (number 24890230, to Takeo Kosaka) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Disclosures

Keisuke Shigeta, Takeo Kosaka, Shigehisa Kitano, Yota Yasumizu, Yasumasa Miyazaki, Ryuichi Mizuno, Toshiaki Shinojima, Eiji Kikuchi, Akira Miyajima, Hitoshi Tanoguchi, Shintaro Hasegawa, and Mototsugu Oya have declared no conflicts of interest.

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    Authors and Affiliations

    1. Department of Urology, Keio University School of Medicine, Tokyo, Japan

      Keisuke Shigeta MD, Takeo Kosaka MD, PhD, Yota Yasumizu MD, Yasumasa Miyazaki MD, Ryuichi Mizuno MD, PhD, Toshiaki Shinojima MD, PhD, Eiji Kikuchi MD, PhD, Akira Miyajima MD, PhD & Mototsugu Oya MD, PhD

    2. Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan

      Shigehisa Kitano MD, PhD

    3. Department of Urology, Isehara Kyodo Hospital, Isehara, Kanagawa, Japan

      Hitoshi Tanoguchi MD, PhD

    4. Department of Urology, Tochigi Medical Center, Utsunomiya, Tochigi, Japan

      Shintaro Hasegawa MD, PhD

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    1. Keisuke Shigeta MD
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    Correspondence to Takeo Kosaka MD, PhD.

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    Keisuke Shigeta and Takeo Kosaka contributed equally to this work.

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    Shigeta, K., Kosaka, T., Kitano, S. et al. High Absolute Monocyte Count Predicts Poor Clinical Outcome in Patients with Castration-Resistant Prostate Cancer Treated with Docetaxel Chemotherapy. Ann Surg Oncol 23, 4115–4122 (2016). https://doi.org/10.1245/s10434-016-5354-5

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