The purpose of this study was to investigate the clinical value of combination of systematic inflammatory factors in predicting the outcomes of primary androgen deprivation therapy (ADT) plus first-generation antiandrogen treatment in metastatic hormone-naïve prostate cancer (mHNPC) patients.
A total of 361 consecutive mHNPC patients from the discovery (n = 165) and validation (n = 196) cohorts were analyzed. All patients received primary ADT with surgical castration or pharmacologic castration accompanied by first-generation antiandrogens. We evaluated the prognostic impact of pretreatment lymphocyte to C-reactive protein ratio (LCR) on overall survival (OS) in both cohorts.
The median follow-up in the discovery and validation cohorts was 43.4 and 50.9 months, respectively. In the discovery cohort, low LCR (using an optimal cutoff threshold of 14,025) was significantly correlated with poor OS compared with high LCR (P < .001). Multivariate analysis revealed that the biopsy Gleason score and LCR were independent prognostic factors for OS. In the validation cohort, low LCR was also significantly correlated with poor OS compared with high LCR (P = .001). A multivariate analysis revealed that the extent of disease on bone scan grade, lactate dehydrogenase, and LCR were all independent predictors of OS.
Pretreatment low LCR is an independent predictor of poor OS in mHNPC patients. This may be informative in predicting the susceptible patients' developing worse outcomes after being treated with primary ADT plus first-generation antiandrogen.
Clinical genitourinary cancer. 2023 May 24 [Epub ahead of print]
Takeshi Sasaki, Toshifumi Takahashi, Sho Sekito, Hideki Kanda, Shinichiro Higashi, Satoru Masui, Takahiro Kojima, Hiroshi Matsuura, Kouhei Nishikawa, Shusuke Akamatsu, Yoshinaga Okugawa, Takashi Kobayashi, Takahiro Inoue
Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Mie, Japan., Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Department of Urology, Aichi Cancer Center Hospital, Aichi, Japan., Department of Urology, Mie Prefectural General Medical Cancer, Mie, Japan., Department of Genomic Medicine, Mie University Hospital, Mie, Japan., Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Mie, Japan. Electronic address: .