Importance of Neutrophil/Lymphocyte Ratio in Prediction of PSA Recurrence after Radical Prostatectomy

Abstract

Background: The aim of this study was to research the importance of the neutrophil to lymphocyte ratio (NLR) in prediction of PSA recurrence after radical prostatectomy, which has not been reported so far. Materials and Methods: The data of 175 patients who were diagnosed with localised prostate cancer and underwent retropubic radical prostatectomy was retrospectively examined. Patient pre-operative hemogram parameters of neutrophil count, lymphocyte count and NLR were assessed. The patients whose PSAs were too low to measure after radical prostatectomy in their follow-ups, and then had PSAs of 0,2 ng/mL were considered as patients with PSA recurrence. Patients with recurrence made up Group A and patients without recurrence made up Group B. Results: In terms of the power of NLR value in distinguishing recurrence, the area under OCC was statistically significant (p<0.001) .The value of 2.494 for NLR was found to be a cut-off value which can be used in order to distinguish recurrence according to Youden index. According to this, patients with a higher NLR value than 2.494 had higher rates of PSA recurrence with 89.7% sensitivity and 92.6% specificity. Conclusions: There are certain parameters used in order to predict recurrence with today's literature data.We think that because NLR is easy to use in clinics and inexpensive, and also has high sensitivity and specificity values, it has the potential to be one of the parameters used in order to predict biochemical recurrence in future.

High preoperative neutrophil–lymphocyte ratio predicts biochemical recurrence in patients with localized prostate cancer after radical prostatectomy

“…However, there is a paucity of studies about the association between NLR and survival outcomes in localized PCa after surgical treatment. Gazel et al [10] recently retrospectively analyzed 175 patients using an NLR cutoff of 2.494 and found that the high-NLR group showed more episodes of recurrence (p < 0.001) and a higher pathological Gleason score (p < 0.001). However, their study included too few subjects and had an ROC that was much higher than those of other studies, which suggests the possibility of hidden bias.…”

“…Multivariate analysis revealed that high NLR was significantly correlated with adverse pathological outcomes of higher pathological stage (HR 1.688; 95 % CI 1.142-2.497; p = 0.009) and extracapsular extension (HR 1.698; 95 % CI 1.146-2.516; p = 0.008). Kaplan-Meier analysis showed significantly worse BCR-free survival (p < 0.001) in patients with a high increased prostate-specific antigen (PSA) level after radical prostatectomy (RP) [10]. Another study showed a significantly worse prognosis in progression-free, metastasis-free, and overall survival of patients with a high NLR and localized PCa after radiotherapy [11].…”

Prognostic impact of preoperative neutrophil-to-lymphocyte ratio after radical prostatectomy in localized prostate cancer

“…In addition, there were only a few studies that investigated the importance of preoperative NLR in prediction of BCR after RP in localized prostate cancer. 15,16 Minardi et al 15 tested the prognostic significance of NLR in the prostate cancer of patients who were candidates for a RP. In that study, they reported that patients with a NLR of 43 had a higher incidence of recurrence.…”

“…8,14 In addition, there were only a few studies that investigated the importance of preoperative NLR in prediction of biochemical recurrence (BCR) after radical prostatectomy (RP) in localized prostate cancer. 15,16 However, the prognostic significance of NLR in terms of survival in patients who have undergone RP for prostate cancer has never been previously evaluated.…”

The preoperative neutrophil‐to‐lymphocyte ratio is not a marker of prostate cancer characteristics but is an independent predictor of biochemical recurrence in patients receiving radical prostatectomy

“…For castration‐resistant prostate cancer (CRPC), a high NLR is reported to be correlated with poor prognosis . Recent reports have also found that an elevated NLR is associated with early biochemical recurrence (BCR) in patients treated with RP . Another study showed that LPCa patients with high NLRs experience worse prognoses in terms of progression‐free, metastasis‐free, and overall survival after radiotherapy .…”