MP6-05 THE ASSOCIATION OF PREOPERATIVE NEUTROPHIL TO LYMPHOCYTE RATIO WITH ONCOLOGIC OUTCOMES FOLLOWING RADICAL PROSTATECTOMY FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Markers II1 Apr 2015MP6-05 THE ASSOCIATION OF PREOPERATIVE NEUTROPHIL TO LYMPHOCYTE RATIO WITH ONCOLOGIC OUTCOMES FOLLOWING RADICAL PROSTATECTOMY FOR PROSTATE CANCER Vidit Sharma, Patrick A. Cockerill, Boyd R. Viers, Laureano J. Rangel, Rachel E. Carlson, R. Jeffrey Karnes, and Matthew K. Tollefson Vidit SharmaVidit Sharma More articles by this author , Patrick A. CockerillPatrick A. Cockerill More articles by this author , Boyd R. ViersBoyd R. Viers More articles by this author , Laureano J. RangelLaureano J. Rangel More articles by this author , Rachel E. CarlsonRachel E. Carlson More articles by this author , R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author , and Matthew K. TollefsonMatthew K. Tollefson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.252AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Elevated neutrophil-lymphocyte ratio (NLR) is a marker of systemic inflammation associated with adverse outcomes in multiple malignancies. Although NLR has prognostic value in the metastatic prostate cancer (PCa) setting, its prognostic role in localized PCa remains unclear. Here we evaluate the association of pre-operative NLR with long-term oncologic outcomes after radical prostatectomy (RP). METHODS A prospectively maintained institutional registry was queried for all men undergoing RP for PCa between 1990–2007. Men without an NLR within 90 days prior to RP and those receiving neoadjuvant therapy were excluded. Ten-year oncologic outcomes were compared between patients with an NLR > 5 and those with an NLR < 5 using univariate and multivariate models. RESULTS We identified 8350 patients with a median follow up of 9.7 years (IQR 6.7-14.1). Overall, 18.7% (1568/8350) of patients had a pre-RP NLR > 5. These patients were more likely to have: pT3/4 disease at RP (22% vs 17.1%, p<0.001), positive margins (33.2% vs 25.8%, p<0.001), adjuvant hormonal (13.8% vs 8.2%, p<0.001) and radiation therapy (4.7% vs 3.2%, p=0.006). Patients with NLR > 5 were also more likely to receive salvage hormonal therapy during follow up (14.0% 11.4%, p=0.004). Table 1 provides the univariate and multivariate hazard ratios comparing 10-year oncologic outcomes between the two NLR cohorts. After controlling for age, preoperative PSA, Gleason score, pathologic stage, and adjuvant hormonal or radiation therapy, NLR > 5 remained a significant predictor of biochemical recurrence (Hazard Ratio 1.13, p=0.02) and demonstrated a trend towards increased overall mortality (Hazard Ratio 1.12, p=0.06). CONCLUSIONS An elevated pre-operative NLR is significantly associated with locally advanced prostate cancer and is thereby associated with higher rates of positive margins and adjuvant therapy. NLR is also independently associated with an increased risk of biochemical recurrence. Further study is warranted to explore the implications of NLR on long term outcomes following radical prostatectomy for localized prostate cancer. Comparing 10 year Oncologic Outcomes between NLR > 5 and NLR < 5 10 year Outcome Univariate Hazard Ratio (95% CI) Univariate P-value Multivariate Hazard Ratio (95% CI) Multivariate P-value Biochemical recurrence 1.10 (0.99-1.22) P=0.07 1.13 (1.02-1.25) P=0.02 Systemic progression 0.92 (0.73-1.15) P=0.45 0.94 (0.74-1.18) P=0.59 Prostate cancer death 0.99 (0.71-1.37) P=0.93 0.98 (0.70-1.36) P=0.88 Death for any reason 1.13 (1.01-1.28) P=0.03 1.12 (1.00-1.26) P=0.06 Multivariate models accounted for age, preoperative PSA, Gleason score, pathologic stage, and adjuvant hormonal or radiation therapy © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e55-e56 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vidit Sharma More articles by this author Patrick A. Cockerill More articles by this author Boyd R. Viers More articles by this author Laureano J. Rangel More articles by this author Rachel E. Carlson More articles by this author R. Jeffrey Karnes More articles by this author Matthew K. Tollefson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...