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Evaluation of neutrophil-to-lymphocyte ratio as a prognostic indicator in a Singapore cohort of patients with clinically localized prostate cancer treated with prostatectomy

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Abstract

Purpose

Recent evidence suggests that the presence of a systemic inflammatory response plays an important role in the progression of several solid tumors. The neutrophil-to-lymphocyte ratio (NLR) has been proposed as easily assessable markers of systemic inflammation and has been shown to represent a prognostic marker in prostate cancer in previous studies.

Methods

Data from 668 patients with localized prostate cancer treated with prostatectomy (open and robot assisted) in Singapore General Hospital from 1998 to 2014 were analyzed. Correlation between NLR and histopathological status was analyzed. Association between NLR and distant metastases-free survival (MFS), cancer-specific survival (CSS), overall survival (OS), and biochemical disease-free survival (BDFS) was assessed.

Results

NLR was not significantly correlated with histopathological status, including Gleason score (≤ 6 versus 7 versus ≥ 8, p = 0.159), lymph node metastasis (negative versus positive, p = 0.159), or surgical margin status (negative versus positive, p = 0.494). NLR was categorized into two groups (< median and ≥ median, median = 2.09) and NLR ≥ 2.09 was not a prognostic factor for decreased MFS (p = 0.609), CSS (p = 0.302), OS (p = 0.722) and BDFS (p = 0.589). No difference was observed for NLR even in high-risk subgroup patients compared to the rest (p = 0.058). The area under the ROC curve (AUC) of NLR as a prognosticator for biochemical recurrence was only 0.53.

Conclusion

Our findings indicate that pre-treatment NLR may not predict prognosis in patients with localized prostate cancer treated with prostatectomy in an Asian cohort.

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Authors and Affiliations

  1. Department of Urology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Yadong Lu, Hong Hong Huang & Weber Kam On Lau

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  1. Yadong Lu
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  2. Hong Hong Huang
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  3. Weber Kam On Lau
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Contributions

YL: Project development, Data Collection, Data Analysis, Manuscript writing; HHH: Data collection and Data Analysis; WLKO: Project development, Manuscript writing and amendment.

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Correspondence to Yadong Lu.

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Lu, Y., Huang, H.H. & Lau, W.K.O. Evaluation of neutrophil-to-lymphocyte ratio as a prognostic indicator in a Singapore cohort of patients with clinically localized prostate cancer treated with prostatectomy. World J Urol 38, 103–109 (2020). https://doi.org/10.1007/s00345-019-02752-4

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  • DOI: https://doi.org/10.1007/s00345-019-02752-4

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