Neutrophil-to-lymphocyte ratio predicts PSA response, but not outcomes in patients with castration-resistant prostate cancer treated with docetaxel

Sümbül, Ahmet Taner; Sezer, Ahmet; Abali, H.; Köse, Faruk; Gültepe, İlhami; Mertsoylu, Hüseyin; Muallaoğlu, Sadık; Özyılkan, Özgür

doi:10.1007/s11255-014-0664-7

Cited by 20 publications

(15 citation statements)

References 23 publications

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“…Soest et al 17 included two independent randomized phase III trials in their paper, we marked the cohorts as Soest1 and Soest2. Finally, 14 publications 12 13 14 15 16 17 18 19 20 21 22 23 24 25 (15 cohorts) with 16,266 patients published between 2012 and 2015 were included in the meta-analysis process. The basic information of the included studies was summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The basic information of the included studies was summarized in Table 1 . 11 studies (12 cohorts) 12 13 14 15 16 17 19 20 21 23 24 were from western countries, 3 studies 18 22 25 were from Asian countries. Of the 14 studies (15 cohorts), 10 studies (11 cohorts) 12 13 14 15 16 17 18 19 21 24 investigated the prognostic role of NLR on OS, 9 studies 14 18 19 20 21 22 23 24 25 investigated prognostic role of NLR on PFS/RFS.…”

Section: Resultsmentioning

confidence: 99%

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Prognostic significance of neutrophil-to-lymphocyte ratio in prostate cancer: evidence from 16,266 patients

Gao

et al. 2016

Sci Rep

106

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This study was aimed to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in patients with prostate cancer (PCa). A meta-analysis including 14 publications (15 cohorts) with 16,266 patients was performed to evaluate the association between NLR and overall survival (OS), progression-free survival (PFS)/recurrence-free survival (RFS) in PCa using hazard ratio (HR) and 95% confidence intervals (95% CI). The combining data showed that increased NLR predict poor OS (HR = 1.38, 95%CI: 1.22–1.56) and PFS/RFS (HR = 1.24, 95%CI 1.05–1.46) in PCa. Stratified analysis by PCa type, sample size, ethnicity and NLR cut-off value revealed that NLR showed consistent prognostic value in metastatic castration-resistant prostate cancer (mCRPC) patients and predict poor PFS/RFS in Asians, but not in Caucasians. These statistical data suggested that increased NLR could predict poor prognosis in patients with PCa.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prognostic significance of neutrophil-to-lymphocyte ratio in prostate cancer: evidence from 16,266 patients

Gao

et al. 2016

Sci Rep

106

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“… 15 Similar results have been reported by Nuhn et al 11 However, another group found that the NLR could only be used to predict PSA response, but not clinical outcomes in mCRPC patients treated with docetaxel. 16 Gazel and his colleagues reported that PCa patients with a high NLR had higher rates of PSA recurrence following RP than those with a low NLR. 17 Similarly, in our study, a positive correlation was observed between high NLR and elevated biochemical recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Neutrophil-to-Lymphocyte Ratio

et al. 2015

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The pretreatment neutrophil-to-lymphocyte ratio (NLR) is reportedly associated with the clinical outcomes of many cancers. However, it has not been widely investigated whether the pretreatment NLR is associated with the pathological characteristics of prostate cancer (PCa) and biochemical recurrence in PCa patients receiving radical prostatectomy (RP).In this cohort study, a total of 1688 PCa patients who had undergone RP were analyzed retrospectively, and a subset of 237 of these patients were evaluated to determine the relationship between pretreatment NLR and biochemical recurrence. Patients were divided into a high-NLR group (NLR ≥2.36) and a low-NLR group (NLR < 2.36) according to the pretreatment NLR. The association between the pretreatment NLR and pathological stage and lymph node involvement was evaluated using logistic regression analysis. Time of biochemical recurrence was determined using the Kaplan–Meier method. Cox's proportional hazard regression model was used to compare the time of biochemical recurrence between the groups.As compared with patients in the low-NLR group, those in the high-NLR group had an increased risk of pT3–4 disease (odds ratio (OR), 1.883; 95% confidence interval (CI), 1.419–2.500; P < .001), and a 1.7-fold increased risk of lymph node involvement (OR, 1.685; 95% CI, 1.101–2.579; P = .016). For the subset of 237 patients, those with a high NLR showed a significantly shorter median biochemical recurrence-free survival time (51.9 months) than those with a low NLR (76.5 months; log-rank test, P = .019). However, multivariate analysis indicated that the NLR was not an independent predictor of biochemical recurrence (hazard ratio, 1.388; 95% CI, 0.909–2.118; P = .129).Our findings suggest that the pretreatment NLR may be associated with pathological stage and lymph node involvement in PCa patients receiving RP, and that PCa patients with a high NLR may have a higher rate of biochemical recurrence following RP than those with a low NLR.

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“…In fact, in a first study by Keizman [ 26 ] where the association between pretreatment NLR and cancer outcome in 156 patients with metastatic castration-resistant prostate cancer treated with ketoconazole was assessed, pretreatment NLR >3 was found to be associated with worse progression-free survival (PFS) but was not associated with OS. In a second retrospective study including 33 patients with metastatic castrate resistant prostate cancer treated with docetaxel and prednisone [ 37 ], an increased NLR was found to be associated with a decreased PSA response.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil count is associated with survival in localized prostate cancer

et al. 2015

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BackgroundIncreasing evidence suggests a close relationship between systemic inflammation and cancer development and progression. The neutrophil to lymphocyte ratio (NLR) has been shown to be an independent prognostic indicator in various advanced and localized cancers. We investigated the influence of markers of systemic inflammation such as leucocyte counts and metabolic co-morbidities on overall survival (OS) after radiotherapy for localized prostate cancer.MethodsWe conducted a retrospective study of patients with localized prostate cancer treated with definitive external beam radiotherapy or brachytherapy. Univariate and multivariate cox proportional hazards models were used to investigate the influence of the following factors on OS: age, neutrophil and lymphocyte counts, neutrophil-to-lymphocyte ratio (NLR), Cancer of the Prostate Risk Assessment (CAPRA) score as well as comorbidities associated with inflammation such as cardiac history, diabetes and use of a statin. A stepwise selection of variable based on the Akaike information criterion (AIC) was used for multivariate analysis.ResultsIn total, 1772 pts were included; blood count data was available for 950 pts. Median age was 68 years (44–87). Actuarial 5 years OS and biochemical recurrence-free survival (BRFS) for the 1772 patients were 93 % and 95 %, respectively, with a median follow-up of 44 months (1–156). On univariate analysis, neutrophil count (p = 0.04), cardiac history (p = 0.008), age (p = 0.001) and CAPRA (p = 0.0002) were associated with OS. Lymphocytes, NLR and comorbidities other than cardiac history were not associated with mortality. On multivariate analysis, neutrophil count (HR = 1.18, 95 % CI: 1.017-1.37, p = 0.028), age (HR = 1.06, 95 % CI: 1.01-1.1, p = 0.008) and CAPRA (HR = 1.16, 95 % CI: 1.03-1.31, p = 0.015) were independent predictors of OS.ConclusionNeutrophil count, as a possible marker of systemic inflammation, appear to be an independent prognostic factor for overall mortality in localized prostate cancer. A validation cohort is needed to corroborate these results.

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Neutrophil-to-lymphocyte ratio predicts PSA response, but not outcomes in patients with castration-resistant prostate cancer treated with docetaxel

Abstract: Although NLR was found effective in predicting the PSA response in docetaxel + prednisone therapy, neither NLR nor any other clinical parameter was found effective in predicting the outcome and the role of NLR in the future of CRPC is questionable.

Cited by 20 publications

References 23 publications

Prognostic significance of neutrophil-to-lymphocyte ratio in prostate cancer: evidence from 16,266 patients

Prognostic significance of neutrophil-to-lymphocyte ratio in prostate cancer: evidence from 16,266 patients

Pretreatment Neutrophil-to-Lymphocyte Ratio

Neutrophil count is associated with survival in localized prostate cancer

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