- Volume 16 Issue 5
DOI QR Code
Importance of Neutrophil/Lymphocyte Ratio in Prediction of PSA Recurrence after Radical Prostatectomy
- Gazel, Eymen (Department of Urology, Turkey Yuksek Ihtisas Training and Research Hospital) ;
- Tastemur, Sedat (Department of Urology, Turkey Yuksek Ihtisas Training and Research Hospital) ;
- Acikgoz, Onur (Department of Urology, Turkey Yuksek Ihtisas Training and Research Hospital) ;
- Yigman, Metin (Department of Urology, Turkey Yuksek Ihtisas Training and Research Hospital) ;
- Olcucuoglu, Erkan (Department of Urology, Turkey Yuksek Ihtisas Training and Research Hospital) ;
- Camtosun, Ahmet (Department of Urology, Turkey Yuksek Ihtisas Training and Research Hospital) ;
- Ceylan, Cavit (Department of Urology, Turkey Yuksek Ihtisas Training and Research Hospital) ;
- Ates, Can (Department of Biostatistics, School of Medicine, Ankara University)
- Published : 2015.03.18
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.
- Cetin B, Berk V, Kaplan MA,, et al (2013). Is the pretreatment neutrophil to lymphocyte ratio an important prognostic parameter in patients with metastaticrenal cell carcinoma? Clin Genitourin Cancer, 11, 141-8. https://doi.org/10.1016/j.clgc.2012.09.001
- Ceylan C, Doluoglu OG, Keles I,et al (2014). Importance of the neutrophil-to-lymphocyte ratio in muscle-invasive and non-muscle invasive bladder tumors. Urologia, 81, 120-4. https://doi.org/10.5301/uro.5000031
- De La Roca RL, Da Cunha IW, Bezerra SM, Da Fonseca FP (2014). Radical prostatectomy and positive surgical margins: relationship with prostate cancer outcome. Int Braz J Urol, 40, 306-15. https://doi.org/10.1590/S1677-5538.IBJU.2014.03.03
- Eerola AK, Soini Y, Paakko P (2006). A high number of tumorinfiltrating lymphocytes are associated with a small tumor size, low tumor stage and a favorable prognosis in operated small cell lung carcinoma. Clin Cancer Res, 6, 1875-81.
- Fichtner J (2000).The management of prostate cancer in patients with a rising prostate-specific antigen level. BJU Int, 86, 181-90.
- Fondevila C, Metges JP, Fuster J et al(2004). P53 and VEGF expression are independent predictors of tumour recurrence and survival following curative resection of gastric cancer. Br J Cancer, 90, 206-15. https://doi.org/10.1038/sj.bjc.6601455
- Hermanns T, Bhindi B, Wei Y, et al (2014). Pre-treatment neutrophil-to-lymphocyte ratio as predictor of adverse outcomes in patients undergoing radicalcystectomy for urothelial carcinoma of the bladder. Br J Cancer, 29, 444-51.
- Kang M, Jeong CW, Choi W, et al (2014). Pre- and post-operative nomograms to predict recurrence-free probability in korean men with clinically localized prostate cancer. PLoS One, 17, 100053.
- Keizman D, Gottfried M, Ish-Shalom M, et al (2012). Pretreatment neutrophil-to-lymphocyte ratio in metastatic castration-resistant prostate cancer patients treated with ketoconazole: association with outcome and predictive nomogram. Oncologist, 17, 1508-14. https://doi.org/10.1634/theoncologist.2012-0125
- Kishi Y, Kopetz S, Chun YS, et al (2009). Blood neutrophil-tolymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy. Ann Surg Oncol, 16, 614-22. https://doi.org/10.1245/s10434-008-0267-6
- Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH (2003). Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis, 6, 283-87 https://doi.org/10.1023/B:AGEN.0000029415.62384.ba
- Naito S (2010). Evaluation and management of prostate-specific antigenrecurrence after radical prostatectomy for localized prostate cancer. J Clin Oncol, 35, 365-74.
- Nuhn P, Vaghasia AM, Goyal J, et al (2013). Association of pretreatment neutrophil-to-lymphocyte ratio (NLR) and overall survival (OS) in patients withmetastatic castrationresistant prostate cancer (mCRPC) treated with first-line docetaxel. BJU Int.
- Ohno Y, Nakashima J, Ohori M, Hatano T, Tachibana M (2010). Pretreatment neutrophil-to-lymphocyte ratio as an independent predictor of recurrence in patients with nonmetastatic renal cell carcinoma. J Urol, 184, 873-78. https://doi.org/10.1016/j.juro.2010.05.028
- Ozyalvacli G, Yesil C, Kargi E, et al (2014).Diagnostic and prognostic importance of the neutrophil lymphocyte ratio in breast cancer. Asian Pac J Cancer Prev, 15, 10363-6.
- Plonis J, Bokums K, Cauce V, et al (2014). Prostate cancer trends in Latvia during 1990-2012: Incidence, prevalence, mortality, and survival rates. Medicina, 50, 313-7. https://doi.org/10.1016/j.medici.2014.11.002
- Ploussard G, Agamy MA, Alenda O,, et al (2011). Impact of positive surgical margins on prostate-specific antigen failure after radicalprostatectomy in adjuvant treatment-naive patients. BJU Int, 107, 1748-54. https://doi.org/10.1111/j.1464-410X.2010.09728.x
- Shebl FM, Hsing AW, Park Y, et al (2014). Non-steroidal antiinflammatory drugs use is associated with reduced risk of inflammation-associated cancers: NIH-AARP study. PLoS One, 9, 114633. https://doi.org/10.1371/journal.pone.0114633
- Sonpavde G, Pond GR, Armstrong AJ, et al (2014). Prognostic impact of the neutrophil-to-lymphocyte ratio in men with metastatic castration-resistant prostate cancer. Clin Genitourin Cancer, 14, 54-8.
- Sumbul AT, Sezer A, Abali H, et al (2014). Neutrophil-to lymphocyte ratio predicts PSA response, but not outcomes in patients with castration resistantprostate cancer treated with docetaxel. Int Urol Nephrol, 46, 1531-5. https://doi.org/10.1007/s11255-014-0664-7
- Tanaka N, Fujimoto K, Hirayama A, et al (2011). Risk-stratified survival rates and predictors of biochemical recurrence after radical prostatectomy in a Nara, Japan, cohort study. Int J Clin Oncol, 16, 553-9. https://doi.org/10.1007/s10147-011-0226-2
- Tanik S, Albayrak S, Zengin K, et al (2014). Is the neutrophillymphocyte ratio an indicator of progression in patients with benign prostatic hyperplasia? Asian Pac J Cancer Prev, 15, 6375-9. https://doi.org/10.7314/APJCP.2014.15.15.6375
- Teeter AE, Presti JC Jr, Aronson WJ, et al (2013). Do nomograms designed to predict biochemical recurrence (BCR) do a better job of predicting more clinically relevant prostate cancer outcomes than BCR? A report from the SEARCH database group. Urology, 82, 53-8. https://doi.org/10.1016/j.urology.2012.10.090
- Wei Y, Jiang YZ, Qian WH (2014). Prognostic role of NLR in urinary cancers: a meta-analysis. PLoS One, 18, 92079.
- High preoperative neutrophil–lymphocyte ratio predicts biochemical recurrence in patients with localized prostate cancer after radical prostatectomy vol.34, pp.6, 2016, https://doi.org/10.1007/s00345-015-1701-6
- The values of neutrophil-lymphocyte ratio and/or prostate-specific antigen in discriminating real Gleason score ≥ 7 prostate cancer from group of biopsy-based Gleason score ≤ 6 vol.17, pp.1, 2017, https://doi.org/10.1186/s12885-017-3614-9
- Pretreatment Neutrophil-to-Lymphocyte Ratio vol.94, pp.41, 2015, https://doi.org/10.1097/MD.0000000000001473
- Prognostic impact of preoperative neutrophil-to-lymphocyte ratio after radical prostatectomy in localized prostate cancer vol.19, pp.3, 2016, https://doi.org/10.1038/pcan.2016.20
- Prognostic utility of neutrophil-to-lymphocyte and platelets-to-lymphocyte ratio in predicting biochemical recurrence post robotic prostatectomy vol.12, pp.8, 2018, https://doi.org/10.2217/bmm-2017-0321
- Elevated preoperative neutrophil–lymphocyte ratio predicts upgrading at radical prostatectomy vol.21, pp.1, 2018, https://doi.org/10.1038/s41391-017-0015-8
- 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 pp.20457634, 2019, https://doi.org/10.1002/cam4.1984