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Prognostic value of selected preoperative inflammation-based scores in patients with high-risk localized prostate cancer who underwent radical prostatectomy

Authors Shu K, Zheng Y, Chen J, Li W, Jiang K

Received 10 September 2017

Accepted for publication 28 February 2018

Published 3 August 2018 Volume 2018:11 Pages 4551—4558


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Ingrid Espinoza

Kunpeng Shu,1,* Yu Zheng,2,* Junru Chen,1 Wenbin Li,3 Ke Jiang4

1Department of Urology, Institute of Urology, 2Department of Thoracic Surgery, 3Huaxi MR Research Center (HMRRC), Department of Radiology, 4Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China

*These authors contributed equally to this work

Background: This study investigated the prognostic value of inflammation-based scores in patients with high-risk localized prostate cancer who underwent radical prostatectomy with or without neoadjuvant androgen deprivation therapy (ADT).
Methods: Inflammation-based scores included the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), and plasma fibrinogen. A total of 440 patients (380 patients treated without neoadjuvant ADT and 60 patients treated with neoadjuvant ADT) were retrospectively evaluated in our medical center. Receiver operating characteristic (ROC) curves and Kaplan–Meier analyses were performed to compare the prognostic value of these scores. Univariate and multivariate Cox regression analyses were also performed.
Results: For all patients, dNLR and PNI were predictive of biochemical recurrence (P=0.041 and <0.001, respectively). Subgroup analysis of neoadjuvant strategies was also performed. For patients treated with neoadjuvant ADT, no selected inflammation-based scores were significantly correlated with biochemical recurrence (P>0.05). In contrast, for patients treated without neoadjuvant ADT, NLR (area under the ROC curve [AUC] =0.576, P=0.033), dNLR (P=0.585 and 0.017), PLR (AUC =0.582, P=0.024), and PNI (AUC =0.622, P<0.001) were predictive of biochemical recurrence. Kaplan–Meier analyses showed that dNLR (P=0.044), PLR (P=0.028), and PNI (P=0.004) were significantly associated with biochemical recurrence. Based on multivariable models, PNI was an independent predictor of biochemical recurrence (hazard ratio: 0.56, 95% confidence interval: 0.35–0.90, P=0.016).
Conclusion: High dNLR, high PLR, and low PNI were associated with poor biochemical recurrence-free survival in patients undergoing radical prostatectomy for high-risk localized prostate cancer not treated with neoadjuvant ADT. In particular, PNI was an independent prognostic factor for biochemical recurrence.

Keywords: biochemical recurrence, prostate cancer, derived neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, prognostic nutritional index

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