Prognostic role of platelet to lymphocyte ratio in prostate cancer

Wang, Jiangfeng; Zhou, Xiaofeng; He, Yuhui; Chen, Xing; Liu, Naibo; Ding, Zhenshan; Li, Junjie

doi:10.1097/md.0000000000012504

Cited by 38 publications

(45 citation statements)

References 36 publications

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“…Conversely, a large patient population study showed that preoperative circulating immune biomarkers such as the NLR and PLR were not associated with postoperative prognosis in black or white men who underwent radical prostatectomy 25 . As to the clinical significance of the PLR in PCa, a high PLR was correlated with poor disease‐free survival and OS, irrespective of ethnicity, tumor stage, and treatment modality 11 . In addition, a past report showed that an increased CRP level is related to PCa risk 26 .…”

Section: Discussionmentioning

confidence: 98%

“…The prostate‐specific antigen (PSA) test is the most standard diagnostic and prognostic noninvasive marker for PCa but it has the disadvantage of not being a useful prognostic marker in advanced cancer states 8,9 . In recent approaches to investigating PCa prognostic predictors, peripheral inflammatory markers are considered to be among the promising parameters 10,11 . Inflammation is a recognized feature of cancer that contributes substantially to the development and progression of malignant tumors 12‐14 .…”

Section: Introductionmentioning

confidence: 99%

“…The peripheral inflammation markers such as the neutrophil‐lymphocyte ratio (NLR), platelet‐lymphocyte ratio (PLR), lactate dehydrogenase (LDH), and C‐reactive protein (CRP) have been studied for their prognostic values in various types of cancers 15‐18 . Several studies showed that these simple, noninvasive, and readily available markers can predict treatment response and survival outcomes also in patients with PCa 10,11 . On the other hand, which inflammation markers are superior and the increased usefulness of combining them has not been well studied.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 In recent approaches to investigating PCa prognostic predictors, peripheral inflammatory markers are considered to be among the promising parameters. 10,11 Inflammation is a recognized feature of cancer that contributes substantially to the development and progression of malignant tumors. [12][13][14] To date, growing evidence has shown that the local immune responses and systemic inflammation play a role in cancer progression and affect the survival of patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17][18] Several studies showed that these simple, noninvasive, and readily available markers can predict treatment response and survival outcomes also in patients with PCa. 10,11 On the other hand, which inflammation markers are superior and the increased usefulness of combining them has not been well studied.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of an inflammatory index for patients with metastatic castration‐resistant prostate cancer

et al. 2020

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Background The inflammatory process has been reported to be involved in the formation and progression of various types of cancer. Recently, a peripheral inflammatory index, combining the derived neutrophils/(leukocytes minus neutrophils) ratio (dNLR) and the lactate dehydrogenase (LDH) level, was proposed as a useful prognostic marker in advanced nonsmall cell lung cancer. The prognostic value of inflammatory markers in prostate cancer has not been established. We aimed to validate the prognostic significance of this peripheral inflammatory index in metastatic castration‐resistant prostate cancer (mCRPC). Methods Clinical data of 196 mCRPC patients were retrospectively collected from multiple institutions. Clinical factors and inflammatory markers at the development of CRPC, including white blood cell count, absolute neutrophil count, dNLR, neutrophil‐lymphocyte ratio, platelet‐lymphocyte ratio, C‐reactive protein (CRP), and LDH levels, were evaluated. The patients were classified into three groups based on the inflammatory index: Good (low dNLR and LDH), Intermediate (high dNLR or LDH), and Poor (high dNLR and LDH). Overall survival (OS) and cancer‐specific survival after CRPC were analyzed using Cox proportional hazard models and Kaplan‐Meier methods. Results The median age and baseline prostate‐specific antigen level were 75 years and 397.15 ng/mL, respectively. On multivariate analysis, dNLR (≥1.51; hazard ratio [HR] = 1.624; P = .0173), LDH (≥upper limit of normal; HR = 2.065; P = .0004), alkaline phosphatase (≥310 U/L; HR = 2.546; P < .0001), and positive N stage (HR = 1.621; P = .048) were associated with poor OS after CRPC, whereas other inflammatory markers including the NLR were not. The Good inflammatory index group showed significantly longer OS after CRPC compared to the Intermediate and Poor groups, with median survivals of 46.2, 28.9, and 16.6 months, respectively. Conclusions The novel inflammatory index combining dNLR and LDH was a useful prognostic parameter in patients with mCRPC. Our analysis suggested that dNLR emerged as a more valuable prognostic marker than NLR.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prognostic value of an inflammatory index for patients with metastatic castration‐resistant prostate cancer

et al. 2020

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Improved outcomes after radiotherapy for prostate cancer: Anticoagulation, antiplatelet therapy, and platelet count as key factors in disease progression

et al. 2020

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BackgroundSeveral studies have suggested that antiplatelet (AP) or anticoagulant (AC) therapy may improve outcome in men with prostate cancer. We evaluated the effects of AP/AC therapy and tested the hypothesis that platelet count may also be associated with outcomes.MethodsA total of 482 patients received primary radiotherapy (median dose 72 Gy) for nonmetastatic prostate cancer; 49% received androgen deprivation therapy. NCCN risk was low/intermediate/high risk in 39%/39%/22%. AP/AC therapy and platelet counts were analyzed with respect to freedom from biochemical failure (FFBF, nadir+2), distant metastasis (FFDM), and cause specific survival (CSS).ResultsAfter a median follow‐up of 103 months, 10‐year FFBF, FFDM, and CSS were 77%, 92%, and 96%, respectively. The 10‐year cumulative incidence of BF and DM (with death as a competing event) was 19% and 7.0%, respectively. The 32% of men on AP/AC therapy had a lower incidence of 10‐year BF (P = .016) and a trend toward a lower incidence of DM (P = .084) and CSS (P = .091). In the entire cohort, lowest platelet quartile (platelet count <187) was associated with higher 10‐year BF (31% vs 16%, P = .0042) but not DM (9.4% vs 5.2%, P = .22) nor CSS (P = .76) compared with those patients with platelet count ≥187. AP/AC therapy was associated with a larger absolute reduction in BF for men with lowest platelet quartile (10‐year BF of 21% vs 38%, P = .092) vs platelet ≥187 (10‐year BF of 10% vs 18%, P = .053). Lowest platelet quartile remained associated with higher BF and DM on multivariable analysis controlling for risk category, WBC, and Hg.ConclusionAP/AC was associated with improved FFBF. Low platelet count was associated with inferior FFBF and FFDM after prostate radiotherapy. This association was tempered when antiplatelet and anticoagulant therapy was administered.

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Future directions in systemic treatment of metastatic hormone-sensitive prostate cancer

2022

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The landscape of advanced prostate cancer treatment has evolved tremendously in past decades. The treatment paradigm has shifted from androgen deprivation therapy (ADT) alone to doublet combinations comprising ADT with docetaxel or an androgen receptor inhibitor, and now triplet therapy involving all 3 classes of agents. Robust clinical data has demonstrated survival benefits with this strategy of upfront treatment intensification. Subgroup analysis has alluded to the importance of tailoring treatment according to metastatic disease burden. However, defining the volume of disease is becoming increasingly controversial due to the advent of next generation molecular imaging. Several trials testing established agents in the castrate-resistant setting are now underway in metastatic hormone sensitive prostate cancer patients. As the treatment milieu is enriched earlier in the disease trajectory, future studies should elucidate biomarkers to further define specific patient populations who will benefit most from treatment intensification and/or de-escalation, with what agents and for what duration.

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Prognostic role of platelet to lymphocyte ratio in prostate cancer

Cited by 38 publications

References 36 publications

Prognostic value of an inflammatory index for patients with metastatic castration‐resistant prostate cancer

Prognostic value of an inflammatory index for patients with metastatic castration‐resistant prostate cancer

Improved outcomes after radiotherapy for prostate cancer: Anticoagulation, antiplatelet therapy, and platelet count as key factors in disease progression

Future directions in systemic treatment of metastatic hormone-sensitive prostate cancer

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