Neutrophil&amp;ndash;lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis

Wang, Zhun; Peng, Shuanghe; Xie, Hui; Guo, Linpei; Jiang, Ning; Shang, Zhiqun; Niu, Yuanjie

doi:10.2147/cmar.s159105

Cited by 11 publications

(9 citation statements)

References 51 publications

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“…In a recent phase III clinical trial of abiraterone acetate plus prednisone versus prednisone alone in patients with mCRPC, a biomarker panel containing CTC number and LDH level was shown to be a surrogate for OS at the individual-patient level [ 30 ]. NLR and PLR are inflammatory parameters that also confer poor outcomes in mCRPC [ 13 , 14 , 31 , 32 ] and are easily available from routine complete blood counts and more stable compared to absolute counts [ 33 ]. However, the additional prognostic value of NLR and PLR has never been evaluated in the context of CTCs.…”

Section: Discussionmentioning

confidence: 99%

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Integration of circulating tumor cell and neutrophil-lymphocyte ratio to identify high-risk metastatic castration-resistant prostate cancer patients

et al. 2021

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Background The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and circulating tumor cells (CTCs) have been associated with survival in castration-resistant prostate cancer (CRPC). However, no study has examined the prognostic value of NLR and PLR in the context of CTCs. Methods Baseline CTCs from mCRPC patients were enumerated using the CellSearch System. Baseline NLR and PLR values were calculated using the data from routine complete blood counts. The associations of CTC, NLR, and PLR values, individually and jointly, with progression-free survival (PFS) and overall survival (OS), were evaluated using Kaplan-Meier analysis, as well as univariate and multivariate Cox models. Results CTCs were detected in 37 (58.7%) of 63 mCRPC patients, and among them, 16 (25.4%) had ≥5 CTCs. The presence of CTCs was significantly associated with a 4.02-fold increased risk for progression and a 3.72-fold increased risk of death during a median follow-up of 17.6 months. OS was shorter among patients with high levels of NLR or PLR than those with low levels (log-rank P = 0.023 and 0.077). Neither NLR nor PLR was individually associated with PFS. Among the 37 patients with detectable CTCs, those with a high NLR had significantly shorter OS (log-rank P = 0.024); however, among the 26 patients without CTCs, the OS difference between high- and low-NLR groups was not statistically significant. Compared to the patients with CTCs and low NLR, those with CTCs and high levels of NLR had a 3.79-fold risk of death (P = 0.036). This association remained significant after adjusting for covariates (P = 0.031). Combination analyses of CTC and PLR did not yield significant results. Conclusion Among patients with detectable CTCs, the use of NLR could further classify patients into different risk groups, suggesting a complementary role for NLR in CTC-based prognostic stratification in mCRPC.

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Section: Discussionmentioning

confidence: 99%

“…Walsh et al first discovered the prognostic value of neutrophil-lymphocyte ratio (NLR) in pre-operative colorectal cancer patients [ 8 ]. Since then, there has been increasing evidence regarding the prognostic value of NLR in other solid tumors [ 9 – 12 ], including CRPC [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Integration of circulating tumor cell and neutrophil-lymphocyte ratio to identify high-risk metastatic castration-resistant prostate cancer patients

et al. 2021

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“…NLR combining of neutrophilia and lymphopenia represents systemic inflammatory response and immune response. It is an independent predictor of poor prognosis for several solid cancers including castration-resistant prostate cancer, cervical adenocarcinoma, lung cancer, and esophageal carcinoma 64–67. Similarly, a study enrolling 84 consecutive penile cancer patients investigated the association between NLR with pathologic LNM and prognosis 24.…”

Section: Discussionmentioning

confidence: 99%

<p>Predictors of inguinal lymph node metastasis in penile cancer patients: a meta-analysis of retrospective studies</p>

Hu¹,

Liu²,

Ren³

et al. 2019

CMAR

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Purpose Inguinal lymph node metastasis (LNM) is one of the most significant prognostic factors for patients with penile cancer. This study aimed to identify potential predictors of inguinal LNM. Patients and methods A comprehensive search of the PubMed, Embase, and Cochrane Library databases for studies that reported predictors of inguinal LNM in penile cancer was performed. Finally, we selected 42 eligible studies with 4,802 patients. Accumulative analyses of odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were performed. All analyses were performed by using Review Manager software version 5.3. Results Among the 4,802 patients, 1,706 (36%) were diagnosed with inguinal LNM. Predictors of LNM included two categories: tumor-associated biomarkers and invasive clinicopathologic characteristics. Biomarker-specific predictors: the program death ligand 1 (PD-L1) overexpression (OR=2.55, p =0.002), higher neutrophil-to-lymphocyte ratio (NLR) (OR=4.22, p =0.010), higher C-reactive protein (CRP) (OR=4.78, p <0.001), squamous cell carcinoma antigen (SCC-Ag) overexpression (OR=8.52, p <0.001), P53 protein overexpression (OR=3.57, p <0.001). Clinicopathological predictors: positive clinical lymph node (cN+) (OR=5.86, p <0.001), high-risk histopathological subtype (OR=14.63, p <0.001) and intermediate-risk subtype (OR=3.37, p <0.001), vertical growth pattern (OR=1.97, p =0.020), higher stage (AJCC: OR=3.66, p <0.001; UICC: OR=2.43, p <0.001), higher tumor grade (OR=3.37, p <0.001), tumor size (>3 cm) (OR=2.00, p =0.002), LVI (OR=3.37, p <0.001), invasion depth (>5 mm) (OR=2.58, p =0.002), nerve invasion (OR=2.84, p <0.001), corpora cavernosum invasion (OR=2.22, p <0.001), corpus spongiosum invasion (OR=1.73, p =0.002) and urethra invasion (OR=1.81, p =0.030). Conclusion Current meta-analysis conclusively identified valuable predictors of inguinal LNM for patients with penile cancer. However, high-quality studies are warranted to further validate our conclusions. The intrinsic link between these predictors needs to be further investigated to create an accurate mathematical prediction model for LNM.

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“…An increased NLR has been reported to be a predictor of survival and therapeutic effects in PCa irrespective of tumor stage and therapy. 10,24 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.…”

Section: Discussionmentioning

confidence: 99%

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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Neutrophil–lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis

Cited by 11 publications

References 51 publications

Integration of circulating tumor cell and neutrophil-lymphocyte ratio to identify high-risk metastatic castration-resistant prostate cancer patients

Integration of circulating tumor cell and neutrophil-lymphocyte ratio to identify high-risk metastatic castration-resistant prostate cancer patients

<p>Predictors of inguinal lymph node metastasis in penile cancer patients: a meta-analysis of retrospective studies</p>

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

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