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Minerva Urologica e Nefrologica 2020 Feb 19

DOI: 10.23736/S0393-2249.20.03662-0


lingua: Inglese

Predictive value of preoperative neutrophil-to-lymphocyte ratio in localized prostate cancer: results from a surgical series at a high-volume institution

Carlo A. BRAVI 1, 2 , Giuseppe ROSIELLO 1, Giuseppe FALLARA 1, Emily VERTOSICK 2, Amy TIN 2, Daniel SJOBERG 2, Marco BIANCHI 1, Elio MAZZONE 1, Alberto MARTINI 1, Paolo DELL’OGLIO 1, Armando STABILE 1, Giorgio GANDAGLIA 1, Nicola FOSSATI 1, Alberto BRIGANTI 1, Francesco MONTORSI 1, Andrew VICKERS 2

1 Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy; 2 Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA


BACKGROUND: To examine the predictive value of neutrophil-to-lymphocyte ratio in localized prostate cancer for surgical pathology and recurrence in patients treated by radical prostatectomy.
METHODS: We evaluated 1 258 patients treated by radical prostatectomy at San Raffaele Hospital between 2011 and 2017 and assessed the association between preoperative neutrophil-to-lymphocyte ratio and surgical pathology (advanced stage, grade group ≥4, nodal involvement, grade discordance between biopsy and surgical pathology) and biochemical recurrence.
RESULTS: The preoperative neutrophil-to-lymphocyte ratio was not significantly associated with advanced stage (≥T3), International Society of Urological Pathology (ISUP) grade (≥4) or discordance. At multivariable analysis, patients with higher neutrophil-to-lymphocyte ratio had lower risk of nodal involvement at final pathology (odds ratio [OR]: 0.77; 95% confidence interval [CI]: 0.64, 0.92; P=0.005). The preoperative level of neutrophil-to-lymphocyte ratio was associated with biochemical recurrence on univariate analysis (OR: 0.81, 95% CI: 0.68, 0.96; P=0.017). Such a relationship was not significant at multivariable analysis adjusting for tumor severity (OR: 0.93, 95% CI: 0.79, 1.09; P=0.4).
CONCLUSIONS: Neutrophil-to-lymphocyte ratio does not have clinical utility for the prediction of adverse pathology and biochemical recurrence. Further research should focus on its value for predicting regional lymph node metastasis.

KEY WORDS: Localized prostate cancer; Radical prostatectomy; Neutrophil-to-lymphocyte ratio; Nodal metastasis; Biochemical recurrence

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