Role of neutrophil-to-lymphocyte ratio in prediction of Gleason score upgrading and disease upstaging in low-risk prostate cancer patients eligible for active surveillance

Authors

  • Mehmet Ilker Gokce Ankara University School of Medicine, department of Urology
  • Semih Tangal Ufuk University School of Medicine, department of Urology
  • Nurullah Hamidi Ankara University School of Medicine, department of Urology
  • Evren Suer Ankara University School of Medicine, department of Urology
  • Muhammed Arif Ibis Ankara University School of Medicine, department of Urology
  • Yasar Beduk Ankara University School of Medicine, department of Urology

DOI:

https://doi.org/10.5489/cuaj.3550

Abstract

Introduction: Active surveillance (AS) is an option for management of low-risk prostate cancer (PCa). However, grade and stage progression is an important consideration. Neutrophil-to-lymphocyte ratio (NLR) is a useful marker of cancer-related inflammation. In this study, we aimed to identify the roles of neutrophil count (NC), lymphocyte count (LC), and NLR to predict Gleason score (GS) upgrading, disease upstaging, and biochemical recurrence rates (BCR) in low-risk PCa patients.

Methods: We retrospectively evaluated data of 210 low-risk PCa patients eligible for AS, but who underwent radical prostatectomy. The roles of NC, LC, and NLR on the GS upgrading, disease upstaging, and BCR rates were investigated. Univariate and multivariate models were used to determine the effect of these parameters. 

Results: There were 104 and 106 patients in the NLR <2.5 and NLR ≥2.5 groups, respectively. GS upgrading in the NLR ≥2.5 group was more common than in the NLR<2.5 group (p=0.04). The NLR ≥2.5 group had significantly higher GS (8‒10; p=0.03). With regard to NLR, the groups were found to have similar rates of disease upstaging (9/104 in NLR <2.5 vs. 16/106 in NLR ≥2.5; p=0.200). BCR rates were also significantly different between groups (p=0.033). NC an LC were not found to be associated with GS upgrading, disease upstaging, or BCR.

Conclusions: NLR is a predictor of GS upgrading and BCR, but not disease upstaging in patients with low-risk PCa. Furthermore, higher NLR was found to be associated with higher GS PCa. NLR is a cost-effective and easily accessible tool that can be used in the decision-making process for treatment of low-risk PCa cases.

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Published

2016-11-10

How to Cite

Gokce, M. I., Tangal, S., Hamidi, N., Suer, E., Ibis, M. A., & Beduk, Y. (2016). Role of neutrophil-to-lymphocyte ratio in prediction of Gleason score upgrading and disease upstaging in low-risk prostate cancer patients eligible for active surveillance. Canadian Urological Association Journal, 10(11-12), E383–7. https://doi.org/10.5489/cuaj.3550

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Section

Original Research