Prognostic value of novel inflammation index for patients with metastatic castration-resistant prostate cancer.

Abstract

212 Background: Inflammation process has been reported to be involved in the development of several types of cancer. Recently, a lung immune prognostic index (LIPI) combining with derived neutrophils/ (leukocytes minus neutrophils) ratio (dNLR) and lactate dehydrogenase (LDH) level was proposed as an useful prognostic marker for advanced non-small cell lung cancer. However, the prognostic value of this index has not been evaluated and we aimed to validate its prognostic ability in metastatic castration resistant prostate cancer (mCRPC). Methods: Clinical data of 248 mCRPC patients were retrospectively collected from multi-institutions. We obtained the clinical factors including age, PSA, Gleason score (GS), tumor stage, white blood cell (WBC) count, dNLR, hemoglobin (Hb), LDH, alkaline phosphatase (ALP) and C-reactive protein (CRP) levels. The prognostic index was defined as poor (high dNLR and LDH), intermediate (high dNLR or LDH) and good (low dNLR and LDH) groups. We analyzed the overall survival (OS) after CRPC using Cox proportional hazard models and the Kaplan-Meier methods. Results: The median age at CRPC and baseline PSA level were 75 years and 458.39 ng/ml, respectively. The median OS after CRPC were 31.7 months. In multivariate analysis, dNLR (≥1.48, HR=1.75, P=0.0096), LDH (≥upper limits of normal, HR=1.94, P=0.0015) and ALP (≥310U/l, HR=2.37, P<0.0001) were independent prognostic factors for OS. The good prognostic index group showed significantly longer OS after CRPC compared with the intermediate and poor groups with the median survival of 46.2, 28.9 and 16.6 months, respectively (shown in Table). Conclusions: Novel inflammation index combined with dNLR and LDH was an useful prognostic marker for mCRPC. Further study with a large scale and treatment specific analysis will be required.[Table: see text]