Prognostic factors for survival among Caucasian, African-American and Hispanic men with androgen-independent prostate cancer

Background: African-American men suffer disproportionately with respect to the incidence and mortality from prostate cancer. The objective of the current study was to define if race was an independent prognostic factor among other variables assessed for survival among men treated for androgen independent prostate cancer. Methods: Between 1988 and 1995, 379 patients with AIPC and clinical progression were referred for novel protocol therapies. Measured variables included: 1) patient age, 2) race or ethnicity, 3) hemoglobin, 4) alkaline phosphatase, 5) serum prostate-specific antigen (PSA) level, 6) time from hormonal ablation to AIPC, 7) number of metastases on bone scan, 8) osseous stage, 9) number of organ systems with metastases and 10) type of treatment for AIPC. Results: Median survival for the cohort was not significantly affected by race, on uni- or multivariate analysis. Multivariate analysis demonstrated that increasing hemoglobin (HR= 0.87 per g, 95% CI [0.81-0.94]) and time to AIPC (HR=0.994, 95% CI [0.990-0.998]) were associated with increased survival while higher osseous stage (HR=1.49, stage I versus II, 95% CI [1.11-1.99]), treatment group [HR=1.68, treatment group I versus II, 95% CI [1.33-2.12]), metastases to three or more organ systems [HR=1.31 versus less than three organs, 95% CI [1.15-1.49]), and advanced age (HR=1.51 forage >70 versus ≤70, 95% CI [1.18-1.94]) were associated with a decrease in survival among patients with AIPC. Conclusion: Independent prognostic variables for survival among patients with AIPC included patient age, serum hemoglobin level, time to androgen-independent disease, treatment group and the extent of metastatic disease. Ethnicity did not adversely affect outcome.