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High preoperative neutrophil–lymphocyte ratio predicts biochemical recurrence in patients with localized prostate cancer after radical prostatectomy

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Abstract

Purpose

To investigate the association between preoperative neutrophil–lymphocyte ratio (NLR) and oncological outcomes in patients with localized prostate cancer (PCa) after radical prostatectomy (RP).

Methods

We retrospectively reviewed the records of 1367 patients who underwent RP between November 2003 and April 2012. Patients who underwent a concurrent biopsy/procedure in other organs, had evidence of acute infection, or had systemic inflammatory disease were excluded. We divided the patients by NLR level and analyzed their perioperative outcomes. To determine NLR significance, we performed a multivariate logistic regression analysis of the pathological adverse outcomes and a Cox proportional hazard analysis of the biochemical recurrence (BCR), which was defined as a prostate-specific antigen level ≥0.2 ng/mL on two consecutive tests.

Results

Among the 1367 patients, 158 (11.6 %) in the high-NLR (≥2.5) group had a higher biopsy Gleason score (p < 0.001), pathological Gleason score (p < 0.001), and pathological stage (p < 0.001) than patients in the low-NLR (<2.5) group (n = 1209, 88.4 %). Multivariate analysis revealed that high NLR was significantly correlated with adverse pathological outcomes of higher pathological stage (HR 1.688; 95 % CI 1.142–2.497; p = 0.009) and extracapsular extension (HR 1.698; 95 % CI 1.146–2.516; p = 0.008). Kaplan–Meier analysis showed significantly worse BCR-free survival (p < 0.001) in patients with a high NLR. A high NLR was a significant predictor of BCR after RP (HR 1.358; 95 % CI 1.008–1.829; p = 0.044).

Conclusions

High NLR was significantly related to unfavorable clinicopathological outcomes and worse BCR-free survival. Further studies are needed to clarify the correlation between NLR and PCa.

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Author contributions

Hakmin Lee and Jong Jin Oh involved in conception and design of study. Hakmin Lee, Seong Jin Jeong, Seok-Soo Byun, Sang Eun Lee, and Sung Kyu Hong contributed to acquisition of data. Hakmin Lee, Seong Jin Jeong, Seok-Soo Byun, Sang Eun Lee, and Sung Kyu Hong performed statistical analysis and interpreted the data. Hakmin Lee and Jong Jin Oh drafted the manuscript. Hakmin Lee, Jong Jin Oh, Seok-Soo Byun, and Sang Eun Lee revised the manuscript with intellectual criticism. And all authors approved the final version of the manuscript to be published.

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Authors and Affiliations

  1. Department of Urology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea

    Hakmin Lee, Seong Jin Jeong, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee & Jong Jin Oh

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  1. Hakmin Lee
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  2. Seong Jin Jeong
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Correspondence to Jong Jin Oh.

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Ethical standard

The study was reviewed and approved by two ethical review boards of both involved institutions. Methods were carried out in accordance with the approved guidelines.

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Lee, H., Jeong, S.J., Hong, S.K. et al. High preoperative neutrophil–lymphocyte ratio predicts biochemical recurrence in patients with localized prostate cancer after radical prostatectomy. World J Urol 34, 821–827 (2016). https://doi.org/10.1007/s00345-015-1701-6

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  • DOI: https://doi.org/10.1007/s00345-015-1701-6

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