Abstract
BackgroundThe pretreatment neutrophil-to-lymphocyte ratio has prognostic value after radical prostatectomy for treating localized prostate cancer. However, the use of postoperative neutrophil-to-lymphocyte ratio has not been evaluated in this population. We investigated the prognostic significance of early postoperative neutrophil-to-lymphocyte ratio after radical prostatectomy for prostate cancer.MethodsWe retrospectively reviewed clinical data from 2,302 patients with localized prostate cancer who underwent radical prostatectomy at our institution between years 2000 and 2010. Only patients with pre- and postoperative complete blood counts with differential results were included. Patients who received neoadjuvant or postoperative adjuvant treatment and those without adequate medical records were excluded. Kaplan-Meier analyses were performed to analyze biochemical recurrence-free survival and overall survival rates. Univariate and multivariate Cox regression models were used for each endpoint.ResultsKaplan-Meier curves showed that high postoperative neutrophil-to-lymphocyte ratio (>3.5) was significantly associated with decreased biochemical recurrence-free survival (p = 0.009) and overall survival (p = 0.010). In the univariate and multivariate Cox regression analyses, high postoperative neutrophil-to-lymphocyte ratio was a significant predictor of biochemical recurrence (hazard ratio 1.270, p = 0.008) and overall survival (hazard ratio 1.437, p = 0.033).ConclusionsOur results demonstrate that postoperative neutrophil-to-lymphocyte ratio is an independent factor for biochemical recurrence and overall survival in patients who underwent radical prostatectomy for prostate cancer. These findings suggest that neutrophil-to-lymphocyte ratio can be a potentially valuable tool for stratifying high-risk patients and facilitating choices of postoperative therapy in patients with prostate cancer.
Highlights
Virchow first proposed a connection between inflammation and cancer in 1876, and findings since suggest that the host inflammatory response plays an important role in cancer development and progression [1,2,3]
Kaplan-Meier curves showed that high postoperative neutrophil-tolymphocyte ratio (>3.5) was significantly associated with decreased biochemical recurrence-free survival (p = 0.009) and overall survival (p = 0.010)
In the univariate and multivariate Cox regression analyses, high postoperative neutrophilto-lymphocyte ratio was a significant predictor of biochemical recurrence and overall survival
Summary
We retrospectively reviewed clinical data from 2,302 patients with localized prostate cancer who underwent radical prostatectomy at our institution between years 2000 and 2010. Patients with pre- and postoperative complete blood counts with differential results were included. Patients who received neoadjuvant or postoperative adjuvant treatment and those without adequate medical records were excluded. Kaplan-Meier analyses were performed to analyze biochemical recurrence-free survival and overall survival rates. Univariate and multivariate Cox regression models were used for each endpoint
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