A Contemporary Prognostic Nomogram for Men with Hormone-Refractory Metastatic Prostate Cancer: A TAX327 Study Analysis

Purpose: To develop a prognostic model and nomogram using baseline clinical variables to predict death among men with metastatic hormone-refractory prostate cancer (HRPC). Experimental Design: TAX327 was a clinical trial that randomized 1,006 men with metastatic HRPC to receive every three week or weekly docetaxel or mitoxantrone, each with prednisone. We developed a multivariate Cox model and nomogram to predict survival at 1, 2, and 5 years. Results: Ten independent prognostic factors other than treatment group were identified in multivariate analysis: ( a ) presence of liver metastases [hazard ratio (HR), 1.66; P = 0.019], ( b ) number of metastatic sites (HR, 1.63 if ≥2 sites; P = 0.001), ( c ) clinically significant pain (HR, 1.48; P < 0.0001), ( d ) Karnofsky performance status (HR, 1.39 if ≤70; P = 0.016), ( e ) type of progression (HR, 1.37 for measurable disease progression and 1.29 for bone scan progression; P = 0.005 and 0.01, respectively), ( f ) pretreatment prostate-specific antigen (PSA) doubling time (HR, 1.19 if