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Thompson JJ, McGovern J, Roxburgh CSD, Edwards J, Dolan RD, McMillan DC. The relationship between LDH and GLIM criteria for cancer cachexia: Systematic review and meta-analysis. Crit Rev Oncol Hematol 2024; 199:104378. [PMID: 38754770 DOI: 10.1016/j.critrevonc.2024.104378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 04/02/2024] [Accepted: 04/30/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Cancer cachexia is a clinical condition characterized by recognizable "sickness behaviors" accompanied by loss of lean body tissue. The Global Leadership on Malnutrition (GLIM) has proposed phenotypic (unintentional weight loss, low body mass index and low muscle mass) and aetiologic (reduced food intake and inflammation or disease burden) diagnostic criteria. Recent work has suggested serum lactate dehydrogenase (LDH) might represent a 3rd aetiologic criteria. Little is known of its relationship with GLIM. A systematic review and meta-analysis of their comparative prognostic value and association was performed. METHODS A search of electronic databases (PubMed, Medline, Ovid, Cochrane) up to February 2023 was used to identify studies that compared the prognostic value of LDH and components of the GLIM criteria in cancer. An analysis of the relationship between LDH and the components of GLIM was undertaken where this data was available. RevMan 5.4.1 was used to perform a meta-analysis for each diagnostic criteria that had 3 or more studies which reported hazard ratios with a 95 per cent confidence interval for overall survival (OS). RESULTS A total of 119 studies were reviewed. Advanced lung cancer was the most studied population. Included in the meta-analysis were 6 studies (n=2165) on LDH and weight loss, 17 studies (n=7540) on LDH and low BMI, 5 studies (n=758) on LDH and low muscle mass, 0 studies on LDH and food intake and 93 studies (n=32,190) on LDH and inflammation. There was a significant association between elevated serum LDH and each of low BMI (OR 1.39, 1.09 - 1.77; p=0.008), elevated NLR (OR 2.04, 1.57 - 2.65; p<0.00001) and elevated CRP (OR 2.58, 1.81 - 3.67; p<0.00001). There was no association between elevated serum LDH and low muscle mass. Only one study presented data on the association between LDH and unintentional weight loss. Elevated LDH showed a comparative OS (HR 1.86, 1.57 - 2.07; p<0.00001) to unintentional weight loss (HR 1.57, 1.23 - 1.99; p=0.0002) and had a similar OS (HR 2.00, 1.70 - 2.34; p<0.00001) to low BMI (HR 1.57, 1.29-2.90; p<0.0001). LDH also showed an OS (HR 2.25, 1.76 - 2.87; p<0.00001) congruous with low muscle mass (HR 1.93, 1.14 - 3.27; p=0.01) and again, LDH conferred as poor an OS (HR 1.77, 1.64-1.90; p<0.00001) as elevated NLR (HR 1.61, 1.48 - 1.77; p<0.00001) or CRP (HR 1.55, 1.43 - 1.69; p<0.00001). CONCLUSION Current literature suggests elevated serum LDH is associated with inflammation in cancer (an aetiologic GLIM criterion), however more work is required to establish the relationship between LDH and the phenotypic components of GLIM. Additionally, elevated serum LDH appears to be a comparative prognosticator of overall survival in cancer when compared to the GLIM criteria.
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Affiliation(s)
- Joshua J Thompson
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
| | - Josh McGovern
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Campbell S D Roxburgh
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Joanne Edwards
- Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Ross D Dolan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
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Salciccia S, Frisenda M, Bevilacqua G, Viscuso P, Casale P, De Berardinis E, Di Pierro GB, Cattarino S, Giorgino G, Rosati D, Del Giudice F, Sciarra A, Mariotti G, Gentilucci A. Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with non-metastatic and metastatic prostate cancer: A meta-analysis and systematic review. Asian J Urol 2024; 11:191-207. [PMID: 38680577 PMCID: PMC11053338 DOI: 10.1016/j.ajur.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/13/2022] [Indexed: 02/08/2023] Open
Abstract
Objective To analyze data available in the literature regarding a possible prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in prostate cancer (PCa) patients stratified in non-metastatic and metastatic diseases. Methods A literature search process was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. In our meta-analysis, the pooled event rate estimated and the pooled hazard ratio were calculated using a random effect model. Results Forty-two articles were selected for our analysis. The pooled risk difference for non-organ confined PCa between high and low NLR cases was 0.06 (95% confidence interval [CI]: -0.03-0.15) and between high and low PLR cases increased to 0.30 (95% CI: 0.16-0.43). In non-metastatic PCa cases, the pooled hazard ratio for overall mortality between high and low NLR was 1.33 (95% CI: 0.78-1.88) and between high and low PLR was 1.47 (95% CI: 0.91-2.03), whereas in metastatic PCa cases, between high and low NLR was 1.79 (95% CI: 1.44-2.13) and between high and low PLR was 1.05 (95% CI: 0.87-1.24). Conclusion The prognostic values of NLR and PLR in terms of PCa characteristics and responses after treatment show a high level of heterogeneity of results among studies. These two ratios can represent the inflammatory and immunity status of the patient related to several conditions. A higher predictive value is related to a high NLR in terms of risk for overall mortality in metastatic PCa cases under systemic treatments.
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Affiliation(s)
- Stefano Salciccia
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Marco Frisenda
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Giulio Bevilacqua
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Pietro Viscuso
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Paolo Casale
- Department of Urology, Humanitas, 20089 Rozzano, MI, Italy
| | - Ettore De Berardinis
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | | | - Susanna Cattarino
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Gloria Giorgino
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Davide Rosati
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Francesco Del Giudice
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Alessandro Sciarra
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Gianna Mariotti
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
| | - Alessandro Gentilucci
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, Italy
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Assayag J, Kim C, Chu H, Webster J. The prognostic value of Eastern Cooperative Oncology Group performance status on overall survival among patients with metastatic prostate cancer: a systematic review and meta-analysis. Front Oncol 2023; 13:1194718. [PMID: 38162494 PMCID: PMC10757350 DOI: 10.3389/fonc.2023.1194718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024] Open
Abstract
Background There is heterogeneity in the literature regarding the strength of association between Eastern Cooperative Oncology Group performance status (ECOG PS) and mortality. We conducted a systematic review and meta-analysis of studies reporting the prognostic value of ECOG PS on overall survival (OS) in metastatic prostate cancer (mPC). Methods PubMed was searched from inception to March 21, 2022. A meta-analysis pooling the effect of ECOG PS categories (≥2 vs. <2, 2 vs. <2, and ≥1 vs. <1) on OS was performed separately for studies including patients with metastatic castration-resistant prostate cancer (mCRPC) and metastatic castration-sensitive prostate cancer (mCSPC) using a random-effects model. Analyses were stratified by prior chemotherapy and study type. Results Overall, 75 studies, comprising 32,298 patients, were included. Most studies (72/75) included patients with mCRPC. Higher ECOG PS was associated with a significant increase in mortality risk, with the highest estimate observed among patients with mCRPC with an ECOG PS of ≥2 versus <2 (hazard ratio [HR]: 2.10, 95% confidence interval [CI]: 1.87-2.37). When stratifying by study type, there was a higher risk estimate of mortality among patients with mCRPC with an ECOG PS of ≥1 versus <1 in real-world data studies (HR: 1.98, 95% CI: 1.72-2.26) compared with clinical trials (HR: 1.32, 95% CI: 1.13-1.54; p < 0.001). There were no significant differences in the HR of OS stratified by previous chemotherapy. Conclusion ECOG PS was a significant predictor of OS regardless of category, previous chemotherapy, and mPC population. Additional studies are needed to better characterize the effect of ECOG PS on OS in mCSPC.
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Affiliation(s)
- Jonathan Assayag
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
| | - Chai Kim
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
| | - Haitao Chu
- Statistical Research and Data Science Center, Global Biometrics and Data Management, Pfizer Inc., New York, NY, United States
| | - Jennifer Webster
- Evidence Generation Platform, Pfizer Inc., New York, NY, United States
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Change of the Neutrophil-to-Lymphocyte Ratio during Treatment: A Potential Prognostic Biomarker in Metastatic Prostate Cancer Treated with Radium-223 Dichloride. Cancers (Basel) 2022; 14:cancers14194606. [PMID: 36230529 PMCID: PMC9559675 DOI: 10.3390/cancers14194606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
The neutrophil to lymphocyte ratio (NLR) at baseline has been shown to have prognostic value in metastatic prostate cancer. Little is known about the importance of a change in the NLR during treatment in patients treated with Radium-223 (223Ra). We investigated the prognostic value of the NLR at baseline and during therapy in patients with metastatic prostate cancer treated with 223Ra and also in patients treated with Docetaxel. We reviewed all patients treated with 223Ra in our center and randomly chosen patients treated with Docetaxel. Patients were stratified according to NLR ≤ 5 and >5 at baseline and at 12 weeks of therapy. The relationship between NLR measured at baseline and at 12 weeks and overall survival (OS) were evaluated. A total of 149 patients treated with 223Ra and 170 with Docetaxel were evaluated. For patients treated with 223Ra, overall survival was significantly better in patients that had both an NLR ≤ 5 at baseline and at 12 weeks. No such effect of NLR was found in patients treated with Docetaxel. In the present study, NLR at baseline and after 12 weeks of therapy was found to be prognostic factor in patients treated with 223Ra but not in those treated with Docetaxel.
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Pisano C, Tucci M, DI Stefano RF, Turco F, Samuelly A, Bungaro M, Vignani F, Tarenghi F, Scagliotti GV, DI Maio M, Buttigliero C. Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with metastatic castration resistant prostate cancer treated with Abiraterone or Enzalutamide. Minerva Urol Nephrol 2021; 73:803-814. [PMID: 33781017 DOI: 10.23736/s2724-6051.21.04186-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are markers of systemic inflammation associated with poor outcome in several solid tumours. We retrospectively investigated the prognostic role of PLR and, secondly, NLR in mCRPC patients treated with Abiraterone Acetate (AA) or Enzalutamide (E), both in pre- and post-docetaxel setting. MATERIALS AND METHODS 225 mCRPC patients treated with AA or E with basal blood count were divided in three groups according to PLR (PLR1 <128; PLR2 128-190; PLR >190) and in two groups according to NLR (<3 vs ≥3). Outcome measures were progression-free survival (PFS) and overall-survival (OS). Univariate and multivariate analyses were performed. RESULTS 110 patients were in PLR1, 58 in PLR2 and 57 in PLR3. Median OS was 22.0, 20.6 and 21.2 months in PLR1, PLR2 and PLR3 (PLR2 vs PLR1: HR 0.97, 95%CI 0.62-1.52, p=0.90; PLR3 vs PLR1: HR 1.37, 95%CI 0.90-2.08, p=0.14). Median PFS was 9.2, 12.7 and 8.5 months in PLR1, PLR2 and PLR3 (PLR2 vs PLR1: HR 0.87, 95%CI 0.59-1.27, p=0.47; PLR3 vs PLR1: HR 1.15, 95%CI 0.80-1.66, p=0.45). 142 patients were in NLR<3 and 83 in NLR≥3. Median OS was 26.5 months in NLR<3 and 17.0 months in NLR≥3 (HR 1.75, 95%CI 1.22-2.51, p=0.02). Median PFS was 10.1 months in NLR<3 and 7.6 months in NLR≥3 (HR 1.37, 95%CI 1.00-1.88, p=0.05). CONCLUSIONS In this retrospective analysis of mCRPC patients treated with AA or E we did not identify a prognostic role of baseline PLR, while we found a significant prognostic role of baseline NLR.
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Affiliation(s)
- Chiara Pisano
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Marcello Tucci
- Medical Oncology, Cardinal Massaia Hospital, Asti, Italy -
| | - Rosario F DI Stefano
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Fabio Turco
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Alessandro Samuelly
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Maristella Bungaro
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Francesca Vignani
- Department of Oncology, Division of Medical Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Federica Tarenghi
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Giorgio V Scagliotti
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Massimo DI Maio
- Department of Oncology, Division of Medical Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Consuelo Buttigliero
- Department of Oncology, Division of Medical Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
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Donate-Moreno MJ, Lorenzo-Sánchez MV, Díaz de Mera-Sánchez Migallón I, Herraiz-Raya L, Esper-Rueda JA, Legido-Gómez O, Rico-Marco S, Salinas-Sánchez AS. Inflammatory markers as prognostic factors in metastatic castration-resistant prostate cancer. Actas Urol Esp 2020; 44:692-700. [PMID: 33010988 DOI: 10.1016/j.acuro.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/23/2020] [Accepted: 08/10/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Inflammatory markers have prognostic value in various tumors due to the role of inflammatory phenomena at different stages of tumor development. The aim of this study is to demonstrate the prognostic value of these markers, as well as other clinical and analytical variables in patients with metastatic castration-resistant prostate cancer (mCRPC). MATERIAL AND METHODS Prospective cohort study carried out on 80 patients diagnosed with mCRPC. Clinical and analytical data were collected, and the following inflammatory markers were estimated: Absolute Neutrophil Count (ANC), Neutrophil-Lymphocyte Ratio (NLR), Total Platelet Count (TPC), Platelet-Lymphocyte Ratio (PLR), Lymphocyte-Monocyte Ratio (LMR) and Systemic Inflammation Index (SII). The values of albumin, hemoglobin (Hb), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were also determined. RESULTS Patients with ANC>7500, NLR>3, PLR>150, LMR>3 and/or SII>535,000, presented significantly lower median survival time than the remaining patients, and TPC was the only marker which did not show a significant association. Moreover, NLR, PLR and SII were inversely correlated with survival time. Patients with hypoalbuminemia, anemia, and elevated LDH values had significantly lower median survival time. Albumin and hemoglobin were directly correlated to overall survival time. The need for analgesia was also associated with shorter survival. CONCLUSION The values of certain inflammatory markers are associated with shorter survival time in patients with mCRPC, and their use in clinical practice can be considered to evaluate the prognosis and estimate survival.
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Affiliation(s)
- M J Donate-Moreno
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - M V Lorenzo-Sánchez
- Facultad de Medicina de Albacete, Departamento de Ciencias Médicas, Área de Urología, Universidad de Castilla La Mancha, Albacete, España
| | | | - L Herraiz-Raya
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - J A Esper-Rueda
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - O Legido-Gómez
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - S Rico-Marco
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - A S Salinas-Sánchez
- Servicio de Urología, Complejo Hospitalario Universitario de Albacete, Albacete, España.
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ROC Analysis Identifies Baseline and Dynamic NLR and dNLR Cut-Offs to Predict ICI Outcome in 402 Advanced NSCLC Patients. JOURNAL OF MOLECULAR PATHOLOGY 2020. [DOI: 10.3390/jmp1010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Neutrophil-to-Lymphocyte Ratio (NLR) and derived Neutrophils-to-(Leukocytes minus neutrophils) Ratio (dNLR) have been proposed as possible biomarkers of response to immune checkpoint inhibitors (ICI). However, in non-small cell lung cancer (NSCLC) studies, various NLR and/or dNLR cut-offs have been used, manly based on previous reports on melanoma. Methods: In this Italian multicenter retrospective study, NLR, dNLR, platelet-to-lymphocyte ratio, albumin, and lactate dehydrogenase (LDH) were longitudinally assessed in patients with stage IV non-small cell lung cancer (NSCLC) treated with ICI. The primary objective was to evaluate if baseline parameters predicted response to ICI, using Receiver Operating Characteristic (ROC) curves. Secondary endpoint was to evaluate if dynamic changing of NLR and dNLR also predicted response. Results: Data of 402 patients were collected and analyzed. Among the baseline parameters considered, NLR and dNLR were the most appropriate biomarkers according to the ROC analyses, which also identified meaningful cut-offs (NLR = 2.46; dNLR = 1.61). Patients with low ratios reported a significantly improved outcome, in terms of overall survival (p = 0.0003 for NLR; p = 0.0002 for dNLR) and progression free survival (p = 0.0004 for NLR; p = 0.005 for dNLR). The role of NLR and dNLR as independent biomarkers of response was confirmed in the Cox regression model. When assessing NLR and dNLR dynamics from baseline to cycle 3, a decrease ≥1.04 for NLR and ≥0.41 for dNLR also predicted response. Conclusions in our cohort, we confirmed that NLR and dNLR, easily assessable on peripheral blood, can predict response at baseline and early after ICI initiation. For both baseline and dynamic assessment, we identified clinically meaningful cut-offs, using ROC curves.
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Li F, Xiang H, Pang Z, Chen Z, Dai J, Chen S, Xu B, Zhang T. Association between lactate dehydrogenase levels and oncologic outcomes in metastatic prostate cancer: A meta-analysis. Cancer Med 2020; 9:7341-7351. [PMID: 32452656 PMCID: PMC7541156 DOI: 10.1002/cam4.3108] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Previous studies have provided evidence of the high expression of lactate dehydrogenase (LDH) in multiple solid tumors; however, its prognostic relationship with metastatic prostate cancer (mPCa) remains controversial. We performed a meta‐analysis to better understand the prognostic potential of LDH in mPCa. Methods In our investigation, we included PubMed, Embase, Web of Science, and Cochrane Library as web‐based resources, as well as studies published before January 2020 on the predictive value of LDH in mPCa. We independently screened the studies according to the inclusion and exclusion criteria, evaluated the quality of the literature, extracted the data, and used RevMan 5.3 and STATA12.0 software for analysis. Result From the 38 published studies, the records of 9813 patients with mPCa were included in this meta‐analysis. We observed that higher levels of LDH in patients with mPCa were significantly associated with poorer overall survival (OS) (HR = 2.17, 95% CI: 1.91‐2.47, P < .00001) and progression‐free survival (PFS) (HR = 1.60, 95% CI: 1.20‐2.13, P = .001). The subgroup analyses indicated that the negative prognostic impact of higher levels of LDH on the oncologic outcomes of mPCa was significant regardless of ethnicity, publication year, sample size, analysis type, treatment type, age, and disease state. Conclusion Our analysis suggested the association between a higher level of LDH and poorer OS and PFS in patients with mPCa. As a parameter that can be conveniently evaluated, the LDH levels should be included as a valuable biomarker in the management of mPCa.
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Affiliation(s)
- Fan Li
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Hui Xiang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Zisen Pang
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Zejia Chen
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Jinlong Dai
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Shu Chen
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Bin Xu
- Department of Urology, Affiliated Hospital of Guilin Medical University, The Second Affiliated Hospital Of Guilin Medical University, Guilin, China
| | - Tianyu Zhang
- Department of Urology, Affiliated Hospital of Guilin Medical University, Guilin, China
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Nieblas-Toscano D, Arenas-Bonilla A, Flores-Martín J, Gutiérrez-Tejero F, Velarde-Muñoz C, Ramos-Alaminos C, Salas-Moreno M, Galisteo-Moya R, Moreno-Jiménez J. Role of the neutrophil/lymphocyte ratio in patients with metastatic castration-resistant prostate cancer treated first-line with abiraterone. Actas Urol Esp 2020; 44:164-171. [PMID: 32035807 DOI: 10.1016/j.acuro.2019.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/25/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION In patients with prostate cancer, high NLR seems to be associated with worse survival. Abiraterone acetate (AA) is a new generation hormonal treatment that has shown to increase PFS and OS in mCRPC. MATERIAL AND METHODS Retrospective analysis of patients treated with AA in our center (December 2012-September 2018). We analyzed the association of the NLR (< or ≥ 3) before and after 6 months of treatment with PSA response, PFS, OS, and hormone sensitivity prior to AA (< or> 12 months). RESULTS We have treated 56 patients with a median age of 82 (62-94), of which 22 (39%) had NLR ≥ 3 before treatment. There is a statistically significant association between the NLR prior to treatment<3 and PSA response, OR=9,444, P=.001, and there was no association with the NLR at 6 months of treatment. Statistically significant differences were found between the groups of NLR<and> 3 prior to treatment with abiraterone in PFS with 15 months of median vs. 9 and P=.008, and in OS with 20 months vs. 9 with P=.014. With respect to the determination of NLR at 6 months, there are no differences in the survival curves between both groups. There are significant differences between the NLR prior to treatment according to the length of hormone sensitivity (P=.026). CONCLUSIONS Our results suggest that NLR could provide relevant information and could act as an early and accessible prognostic marker in patients with mCRPC in first line treatment with Abiraterone.
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Stangl-Kremser J, Mari A, Suarez-Ibarrola R, D'Andrea D, Korn SM, Pones M, Kramer G, Karakiewicz P, Enikeev DV, Glybochko PV, Briganti A, Shariat SF. Development of a prognostic model for survival time prediction in castration-resistant prostate cancer patients. Urol Oncol 2020; 38:600.e9-600.e15. [PMID: 31953003 DOI: 10.1016/j.urolonc.2019.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/31/2019] [Accepted: 11/20/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND To identify predictors of survival in patients treated with docetaxel chemotherapy for castration-resistant prostate cancer (CRPC). METHODS We retrospectively analyzed clinical data from 186 patients who underwent docetaxel chemotherapy for CRPC from 2005 to 2016 at a single center. Pretreatment baseline variables including demographic and clinicopathological data were reviewed. Disease progression was defined by imaging and/or consecutive prostate-specific antigen (PSA) elevation. The systemic immune-inflammation index (SII), the modified Glasgow Prognostic Score (mGPS), and the neutrophil-lymphocyte ratio (NLR) were calculated. Univariable and multivariable Cox proportional hazards regression analyses reporting hazard ratios assessed the risk for disease progression and overall survival (OS). A survival nomogram was constructed. RESULTS Most patients (n = 139, 74.7%) completed at least 6 cycles of docetaxel chemotherapy. 156 patients (82.9%) experienced disease progression during the studied period. Only mGPS was independently associated with disease progression in a multivariable model (P < 0.01). During the studied period, 98 patients (52.1%) died. The built survival nomogram included statistically significant variables for OS in univariable analysis: hemoglobin, PSA, alkaline phosphatase (AP), lactate dehydrogenase, SII, neutrophil-lymphocyte ratio, mGPS, and site of metastases; and had a concordance index of 0.703. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of above 40%. In multivariable analysis, only AP (P = 0.02), hemoglobin and PSA (P < 0.01, respectively) remained associated with OS. CONCLUSIONS PSA, AP, and hemoglobin are independent prognosticators for OS. Although mGPS is a promising marker for tumor progression and SII is a plausible prognostic marker for OS, valid integration of inflammatory indices into a prognostic model requires validation studies. Predictive and prognostic biomarkers are desperately needed to guide physicians in treatment counseling given the heterogeneous nature of CRPC and the plethora of effective therapies.
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Affiliation(s)
- Judith Stangl-Kremser
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Andrea Mari
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Rodrigo Suarez-Ibarrola
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - David D'Andrea
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Stephan M Korn
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Mario Pones
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Gero Kramer
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | | | - Dimitri V Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Petri V Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Alberto Briganti
- Department of Urology and Division of Experimental Oncology, URI, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Shahrokh F Shariat
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, Motol Hospital, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
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11
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Systemic immune-inflammation index, serum albumin, and fibrinogen impact prognosis in castration-resistant prostate cancer patients treated with first-line docetaxel. Int Urol Nephrol 2019; 51:2189-2199. [PMID: 31456101 DOI: 10.1007/s11255-019-02265-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/22/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate the prognostic value of pretreatment plasma systemic immune-inflammation index (SII), albumin, and fibrinogen levels in metastatic castration-resistant prostate cancer (mCRPC) patients treated with first-line docetaxel and to screen out the patients with the greatest risk for poor prognosis. METHODS The plasma SII, albumin, and fibrinogen levels were examined before treatment and analyzed with patient clinicopathological parameters and overall survival (OS). The survival analysis was performed using the Kaplan-Meier method, and prognostic factors were assessed using the Cox proportional hazard regression model. RESULTS The incidences of elevated SII level, hypoproteinemia, and hyperfibrinogenemia were 52.51%, 25.14%, and 27.93%, respectively. SII level was associated with neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) (P < 0.001). Albumin level was found closely correlated with ECOG PS (P = 0.006), PLR (P = 0.042), and hemoglobin (P = 0.009), but not other parameters. Elevated plasma fibrinogen level was significantly associated with Eastern Cooperative Oncology Group performance status (ECOG PS) (P = 0.009), visceral metastases (P < 0.001), and PLR (P = 0.001). In multivariate Cox regression model, visceral metastases SII (HR 2.133, 95% CI 1.163-3.913; P = 0.014), albumin (HR 0.540, 95% CI 0.307-0.949; P = 0.032), and fibrinogen (HR 1.888, 95% CI 1.069-3.335; P = 0.029) were further confirmed to be the independent prognostic factors for OS. Of the three target parameters, we found that patients with none abnormalities of the three parameters showed the best prognosis, and patients with at least any two abnormalities of them showed markedly worse prognosis than patients with any one abnormalities of the three parameters (P < 0.001). CONCLUSIONS Pretreatment SII, albumin, and fibrinogen are independent prognostic factors in mCRPC patients treated with first-line docetaxel. Moreover, the combined use of SII, albumin, and fibrinogen levels may help us to identify the high-risk populations for treatment decisions.
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12
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Mori K, Kimura S, Parizi MK, Enikeev DV, Glybochko PV, Seebacher V, Fajkovic H, Mostafaei H, Lysenko I, Janisch F, Egawa S, Shariat SF. Prognostic Value of Lactate Dehydrogenase in Metastatic Prostate Cancer: A Systematic Review and Meta-analysis. Clin Genitourin Cancer 2019; 17:409-418. [PMID: 31558410 DOI: 10.1016/j.clgc.2019.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/03/2019] [Accepted: 07/15/2019] [Indexed: 02/08/2023]
Abstract
The purpose of this study was to assess the prognostic value of lactate dehydrogenase (LDH) in patients with metastatic prostate cancer (PC). A systematic review and meta-analysis was performed in March 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared patients with PC with high versus low LDH to determine the predictive value of LDH for overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). We performed a formal meta-analysis for both OS and PFS. A total of 59 articles with 14,851 patients were included in the systematic review and 45 studies with 12,224 patients for the qualitative assessment. High LDH was associated with both worse OS (pooled hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.75-2.44) and PFS (pooled HR, 1.08; 95% CI, 1.01-1.16). In subgroup analyses of both patients with castration-resistant prostate cancer (CRPC) and those with hormone-sensitive prostate cancer (HSPC), LDH was associated with OS (pooled HR, 2.02; 95% CI, 1.69-2.42 and pooled HR, 2.25; 95% CI, 1.78-2.84, respectively). In patients with CRPC, LDH was associated with OS in those treated with docetaxel systemic chemotherapy and androgen receptor-axis-targeting agents (pooled HR, 2.03; 95% CI, 1.37-3.00 and pooled HR, 1.79; 95% CI, 1.25-2.57, respectively). Elevated serum levels of LDH were associated with an increased risk of mortality and progression in patients with metastatic PC. LDH was independently associated with OS in both patients with CRPC and HSPC. LDH could be integrated into prognostic tools that help guide treatment strategy, thereby facilitating the shared decision-making process.
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Affiliation(s)
- Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shoji Kimura
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mehdi Kardoust Parizi
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Teheran, Iran
| | - Dmitry V Enikeev
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Petr V Glybochko
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Harun Fajkovic
- Department of Urology, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
| | - Hadi Mostafaei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Hamburg, Hamburg, Germany
| | - Ivan Lysenko
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Florian Janisch
- Department of Urology, Medical University of Vienna, Vienna, Austria; Research Center for Evidence-based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
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13
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Onal C, Sedef AM, Kose F, Oymak E, Guler OC, Sumbul AT, Aksoy S, Akkus Yildirim B, Besen AA, Muallaoglu S, Mertsoylu H, Ozyigit G. The hematologic parameters in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate. Future Oncol 2019; 15:1469-1479. [DOI: 10.2217/fon-2018-0635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Currently, there are no predictive markers of response to abiraterone. We calculated neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline and at 4 and 12 weeks after initiation of abiraterone, and we evaluated prostate-specific antigen (PSA) response every 4 weeks in 102 metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone either pre- or postchemotherapy. With a median follow-up was 24.0 months (range: 0.3–54.9), median overall survival (OS) was 20.8 months. High-NLR patients who remained high or who returned to low NLR after 4 and 12 weeks showed significantly worse OS than patients with low baseline NLR. NLR and prostate-specific antigen response to abiraterone was a significant predictor of OS and progression-free survival (PFS) in metastatic castration-resistant prostate cancer patients treated with abiraterone delivered either pre- or postchemotherapy.
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Affiliation(s)
- Cem Onal
- Department of Radiation Oncology, Baskent University Faculty of Medicine, 01120 Adana, Turkey
| | - Ali Murat Sedef
- Division of Medical Oncology, Adana City Hospital, Adana, Turkey
| | - Fatih Kose
- Division of Medical Oncology, Baskent University Faculty of Medicine, 01120 Adana, Turkey
| | - Ezgi Oymak
- Division of Radiation Oncology, Iskenderun Gelisim Hospital, Hatay, Turkey
| | - Ozan Cem Guler
- Department of Radiation Oncology, Baskent University Faculty of Medicine, 01120 Adana, Turkey
| | - Ahmet Taner Sumbul
- Division of Medical Oncology, Baskent University Faculty of Medicine, 01120 Adana, Turkey
| | - Sercan Aksoy
- Division of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Berna Akkus Yildirim
- Department of Radiation Oncology, Baskent University Faculty of Medicine, 01120 Adana, Turkey
| | - Ali Ayberk Besen
- Division of Medical Oncology, Baskent University Faculty of Medicine, 01120 Adana, Turkey
| | - Sadık Muallaoglu
- Division of Radiation Oncology, Iskenderun Gelisim Hospital, Hatay, Turkey
| | - Huseyin Mertsoylu
- Division of Medical Oncology, Baskent University Faculty of Medicine, 01120 Adana, Turkey
| | - Gokhan Ozyigit
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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14
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Peng H, Luo X. Prognostic significance of elevated pretreatment systemic inflammatory markers for patients with prostate cancer: a meta-analysis. Cancer Cell Int 2019; 19:70. [PMID: 30962764 PMCID: PMC6434630 DOI: 10.1186/s12935-019-0785-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/15/2019] [Indexed: 02/06/2023] Open
Abstract
Background Pretreatment inflammatory factors, including neutrophil, lymphocyte, platelet and monocyte counts as well as the ratios between them such as neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and lymphocyte–monocyte ratio (LMR) have been suggested as potential prognostic predictors for patients with prostate cancer (PCa). However, the prognostic effects remain controversial. Therefore, the goal of this study was evaluate the prognostic values of these markers for PCa patients using a meta-analysis. Methods Potentially relevant publications in PubMed and Cochrane Library were searched. Pooled hazard ratio (HR) with 95% confidence interval (CI) for overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), recurrence free survival (RFS) and distant metastases-free survival (DMFS) were determined using a fixed or random effects model by STATA 13.0 software. Results Thirty-two studies involving 21,949 participants were included. Our pooled results demonstrated that a high pretreatment NLR (HR = 1.55, 95% CI 1.37–1.76), PLR (HR = 1.72; 95% CI 1.36–2.18), neutrophil (HR = 1.10; 95% CI 1.03–1.18 and monocyte counts (HR = 2.25; 95% CI 1.67–3.05) predicted inferior OS, while elevated pretreatment LMR (HR = 2.27; 95% CI 1.76–2.94) was correlated with favorable OS. Furthermore, the higher NLR (HR = 1.62; 95% CI 1.29–2.04) and monocyte counts (HR = 1.75; 95% CI 1.36–2.25), but lower LMR predicted worse PFS (HR = 2.18; 95% CI 1.58–3.02); poor RFS was only associated with NLR (HR = 1.12; 95% CI 1.04–1.20). The subgroup analysis showed that the higher NLR may be a predictive factor for OS only in patients with mCRPC and undergoing chemotherapy; while the higher PLR was only significantly associated with OS in localized PCa regardless of treatment. Conclusion This meta-analysis reveals that pretreatment NLR, PLR, LMR, neutrophil, and monocyte counts may be effective predictive biomarkers for prognosis in patients with PCa.
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Affiliation(s)
- Hao Peng
- Department of Urological Surgery, Zhoukou Central Hospital of Henan Province, No. 26 Renmin East Road, Chuanhui District, Zhoukou, 466000 China
| | - Xiaogang Luo
- 2State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai, 201620 China
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15
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Guo J, Fang J, Huang X, Liu Y, Yuan Y, Zhang X, Zou C, Xiao K, Wang J. Prognostic role of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in prostate cancer: A meta-analysis of results from multivariate analysis. Int J Surg 2018; 60:216-223. [PMID: 30468905 DOI: 10.1016/j.ijsu.2018.11.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/06/2018] [Accepted: 11/10/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The prognostic role of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with prostate cancer (PCa) remains inconsistent. Here we quantify the prognostic impact of these biomarkers and assess their consistency in PCa. MATERIALS AND METHODS We systematically searched PubMed, Web of Science, and Embase for eligible studies embracing multivariate results. The Newcastle-Ottawa Scale were used to assess the study quality. Pooled hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated. RESULTS A total of 7228 patients from 18 studies were included in the meta-analysis. Overall, elevated pretreatment NLR was associated with poor overall survival (OS, HR 1.58, 95% CI 1.41-1.78, P < 0.001), progression-free survival (PFS, HR 1.95, 95% CI 1.53-2.49, P < 0.001) and biochemical recurrence-free survival (BRFS, HR 1.37, 95% CI 1.07-1.75, P = 0.011). And high pretreatment PLR was correlated with more inferior PFS (HR 1.62, 95% CI 1.20-2.19, P = 0.002), OS (HR 1.70, 95% CI 1.34-2.15, P < 0.001) and cancer-specific survival (CSS, HR 2.02, 95% CI 1.24-3.29, P = 0.005). Moreover, the subgroup analyses did not alter the direction of results for OS and PFS. CONCLUSION Based on these findings, elevated NLR and PLR was associated with poor oncologic outcomes, and they can serve as prognostic factors in PCa patients.
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Affiliation(s)
- Jinan Guo
- Department of Urology/Shenzhen Urology Minimally Invasive Engineering Center, The Second Clinical Medical College of Jinan University/Shenzhen People's Hospital, Shenzhen, Guangdong Province, China; The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China
| | - Jiequn Fang
- Department of Urology/Shenzhen Urology Minimally Invasive Engineering Center, The Second Clinical Medical College of Jinan University/Shenzhen People's Hospital, Shenzhen, Guangdong Province, China; The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China
| | - Xiangjiang Huang
- Department of Urology/Shenzhen Urology Minimally Invasive Engineering Center, The Second Clinical Medical College of Jinan University/Shenzhen People's Hospital, Shenzhen, Guangdong Province, China; The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China
| | - Yanfeng Liu
- Department of Urology/Shenzhen Urology Minimally Invasive Engineering Center, The Second Clinical Medical College of Jinan University/Shenzhen People's Hospital, Shenzhen, Guangdong Province, China; The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China
| | - Yeqing Yuan
- Department of Urology/Shenzhen Urology Minimally Invasive Engineering Center, The Second Clinical Medical College of Jinan University/Shenzhen People's Hospital, Shenzhen, Guangdong Province, China; The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China
| | - Xueqi Zhang
- Department of Urology/Shenzhen Urology Minimally Invasive Engineering Center, The Second Clinical Medical College of Jinan University/Shenzhen People's Hospital, Shenzhen, Guangdong Province, China; The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China
| | - Chang Zou
- The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China; Clinical Medical Research Center, Shenzhen People's Hospital, Shenzhen, Guangdong Province, China
| | - Kefeng Xiao
- Department of Urology/Shenzhen Urology Minimally Invasive Engineering Center, The Second Clinical Medical College of Jinan University/Shenzhen People's Hospital, Shenzhen, Guangdong Province, China; The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China.
| | - Jianhong Wang
- The Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, the Shenzhen Cell Therapy Public Service Platform, Shenzhen, Guangdong Province, China.
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16
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Fu SYF, Chi KN. Developing prognostic models for advanced prostate cancer when the goal line keeps changing. Ann Oncol 2018; 29:2155-2157. [PMID: 30307525 DOI: 10.1093/annonc/mdy419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- S Y F Fu
- Division of Medical Oncology, Department of Medicine, University of British Columbia, BC Cancer, Vancouver
| | - K N Chi
- Division of Medical Oncology, Department of Medicine, University of British Columbia, BC Cancer, Vancouver; Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada.
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17
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Ohno Y. Role of systemic inflammatory response markers in urological malignancy. Int J Urol 2018; 26:31-47. [PMID: 30253448 DOI: 10.1111/iju.13801] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/20/2018] [Indexed: 12/14/2022]
Abstract
The systemic inflammatory response is associated with survival in patients with a variety of cancers. This inflammatory response is measured in the peripheral blood, and can be monitored using two categories of indices: concentration of specific serum proteins (albumin, C-reactive protein) and differential blood cell count (neutrophils, lymphocytes and platelets). Furthermore, combinations of these indices, such as the Glasgow Prognostic Score, which consists of the serum C-reactive protein and albumin level; the neutrophil-to-lymphocyte ratio; the platelet-to-lymphocyte ratio; and the prognostic nutritional index, which is based on peripheral blood lymphocyte count and serum albumin level, have also been evaluated and compared in cancer research. To date, there are hundreds of studies that have shown the prognostic value of systemic inflammatory response markers in patients with urological cancer. Most studies have evaluated the prognostic and predictive role of the pretreatment value of the markers, although some have focused on the role of the post-treatment value at specific points during the clinical course. The advantages of systemic inflammatory response markers are that they are easily measurable and inexpensive in the clinical setting. However, it is important to consider how clinicians use these markers in clinical practice. The present review provides a concise overview regarding systemic inflammatory markers in urological cancers, specifically C-reactive protein, Glasgow Prognostic Score/modified Glasgow Prognostic Score, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and prognostic nutritional index.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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18
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Wang Z, Peng S, Xie H, Guo L, Jiang N, Shang Z, Niu Y. Neutrophil-lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis. Cancer Manag Res 2018; 10:3599-3610. [PMID: 30271208 PMCID: PMC6149871 DOI: 10.2147/cmar.s159105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background The prognostic value of neutrophil–lymphocyte ratio (NLR) in patients with castration-resistant prostate cancer (CRPC) had been investigated in previous studies; however, the results remain inconsistent. This study was aimed to investigate the prognostic value of NLR in CRPC patients. Materials and methods Literature was identified from PubMed, Embase, Web of Science, and Cochrane, which investigated the relationship between pretreatment NLR and prognosis in CRPC patients. HRs for overall survival (OS) and progression-free survival (PFS) were extracted from eligible studies. Heterogeneity was assessed using the I2 value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg’s funnel plot test. Results A total of 5,705 patients from 16 studies were included in this analysis. The pooled results showed that an elevated NLR predict poor OS (pooled HR = 1.52, 95% CI: 1.41–1.63, P<0.001) and PFS (pooled HR = 1.50, 95% CI: 1.21–1.85, P<0.001) in patients with CRPC. Subgroup analysis revealed that an elevated NLR significantly predicted poor OS in Asian studies group (HR = 2.43, 95% CI: 1.47–4.01, P=0.001). The elevated NLR also significantly predicted poor PFS in Asian studies group (HR = 1.99, 95% CI: 1.30–3.06, P=0.002). Conclusion This study suggests that an elevated NLR predict poor prognosis in patients with CRPC.
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Affiliation(s)
- Zhun Wang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Shuanghe Peng
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Hui Xie
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Linpei Guo
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Ning Jiang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Zhiqun Shang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
| | - Yuanjie Niu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China, ,
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19
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Li D, Lv H, Hao X, Hu B, Song Y. Prognostic value of serum alkaline phosphatase in the survival of prostate cancer: evidence from a meta-analysis. Cancer Manag Res 2018; 10:3125-3139. [PMID: 30214305 PMCID: PMC6124801 DOI: 10.2147/cmar.s174237] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Many studies have evaluated the relationship between alkaline phosphatase (ALP) and the prognosis for prostate cancer (PCa). But they have not reached a widespread consensus yet. Therefore, we completed a meta-analysis to ascertain the significance of ALP and the prognosis for PCa. METHODS A literature search was performed in the PubMed, Embase, and Web of Science databases. HRs concerning overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) were extracted to evaluate the impacts of ALP on the prognosis for PCa. Subgroup analyses were conducted on different study types, regions, sample sizes, and cutoff values. Sensitivity analysis was performed by removing one study in sequence. RESULTS A total of 63 studies from 54 articles with 16,135 patients were included in this meta-analysis. The pooled results indicated that high baseline ALP was associated with obviously poor OS (HR=1.74, 95% CI: 1.47-2.06) and PFS (HR=1.60, 95% CI: 1.13-2.26) in patients with PCa. The pooled HR for bone-specific ALP and OS was 1.76 (95% CI: 1.45-2.15). However, no association between ALP and CSS (HR=1.002, 95% CI: 0.998-1.005) was found for PCa. The results of subgroup analyses were all in accordance with the main findings. Sensitivity analysis suggested that no single study could affect the stability of the results. CONCLUSION High serum ALP is significantly associated with poor OS and PFS except for CSS in PCa. ALP is an efficient and convenient biomarker for PCa prognosis.
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Affiliation(s)
- Dongyang Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China,
| | - Hang Lv
- Department of Urology, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical University, Shenyang, Liaoning 110042, P.R. China,
| | - Xuanyu Hao
- Department of Rheumatology and Immunology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110022, P.R. China
| | - Bin Hu
- Department of Urology, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical University, Shenyang, Liaoning 110042, P.R. China,
| | - Yongsheng Song
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China,
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20
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Yersal Ö, Odabaşi E, Özdemir Ö, Kemal Y. Prognostic significance of pre-treatment neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with glioblastoma. Mol Clin Oncol 2018; 9:453-458. [PMID: 30233797 DOI: 10.3892/mco.2018.1695] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/08/2018] [Indexed: 02/06/2023] Open
Abstract
Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumour in adults. Identification of accessible and cost-effective prognostic factors may better guide adjuvant treatment-related decisions. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of host inflammatory response, and their increase has recently been shown to be a poor prognostic factor in several malignancies. The aim of the present study was to investigate the prognostic value of preoperative NLR and PLR in GBM patients. Between 2012 and 2017, 104 patients who had undergone surgery for GBM were considered for adjuvant therapy in our institution. Of those, 80 patients with evaluable pre-corticosteroid full blood count results were identified and included in the final analysis. The Eastern Cooperative Oncology Group performance status, localization, radiochemotherapy and second-line systemic therapy were found to be independent prognostic indicators for progression-free and overall survival. The median overall survival was 13.2 months. Patients with NLR <4 had a better median overall survival of 10.7 vs. 7.8 months in patients with NLR >4; however, this difference was not statistically significant (P>0.05). Overall survival also did not differ significantly between patients with low and those with high PLR values (10.2 vs. 15.2 months, respectively; P=0.105). In conclusion, the results of the present study suggest that pre-treatment NLR and PLR do not have prognostic value in GBM patients; however, large-scale trials are required to confirm these findings.
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Affiliation(s)
- Özlem Yersal
- Department of Medical Oncology, Adnan Menderes University, Aydın 09010, Turkey
| | - Eylem Odabaşi
- Department of Radiation Oncology, Samsun Research and Training Hospital, Samsun 05000, Turkey
| | - Özge Özdemir
- Department of Radiation Oncology, Samsun Research and Training Hospital, Samsun 05000, Turkey
| | - Yasemin Kemal
- Department of Medical Oncology, Samsun Research and Training Hospital, Samsun 05000, Turkey
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21
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Le PH, Liang KH, Chang ML, Hsu CW, Chen YC, Lin CL, Lin WR, Lai MW, Yeh CT. Clinical Predictors for Neutrophil-to-Lymphocyte Ratio Changes in Patients with Chronic Hepatitis B Receiving Peginterferon Treatment. ACTA ACUST UNITED AC 2018; 31:723-729. [PMID: 28652447 DOI: 10.21873/invivo.11121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND A lower neutrophil-to-lymphocyte ratio (NLR) was found to be associated with better clinical outcomes in hepatitis B-related liver cirrhosis and hepatocellular carcinoma. We aimed to identify pre-therapeutic variables capable of predicting NLR changes in patients with hepatitis B receiving peginterferon therapy. PATIENTS AND METHODS The baseline clinicopathological data were analyzed to correlate with NLR changes before and 1 year after peginterferon treatment in 71 patients with hepatitis B. RESULTS Univariate analysis revealed that pre-treatment NLR itself negatively predicted NLR changes following peginterferon treatment (odds ratio(OR)=0.320, p=0.013). Further analysis identified pre-treatment NLR, hemoglobin and hepatitis B surface antigen level as independent predictors for NLR changes (adjusted p=0.028, 0.005, and 0.028, respectively). A predictive score composed of these three factors had an area under the curve of 76.5% (p<0.001). CONCLUSION Pretreatment NLR, hemoglobin and hepatitis B surface antigen level in combination, effectively predicted NLR changes following peginterferon treatment.
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Affiliation(s)
- Puo-Hsien Le
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Kung-Hao Liang
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan, R.O.C
| | - Ming-Ling Chang
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Chao-Wei Hsu
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Yi-Cheng Chen
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Chih-Lang Lin
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Wey-Ran Lin
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Ming-Wei Lai
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
| | - Chau-Ting Yeh
- Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C. .,Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.,Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan, R.O.C
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22
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Dreussi E, Ecca F, Scarabel L, Gagno S, Toffoli G. Immunogenetics of prostate cancer: a still unexplored field of study. Pharmacogenomics 2018; 19:263-283. [PMID: 29325503 DOI: 10.2217/pgs-2017-0163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The immune system is a double-edged sword with regard to the prostate cancer (PCa) battle. Immunogenetics, the study of the potential role of immune-related polymorphisms, is taking its first steps in the treatment of this malignancy. This review summarizes the most recent papers addressing the potential of immunogenetics in PCa, reporting immune-related polymorphisms associated with tumor aggressiveness, treatment toxicity and patients' prognosis. With some peculiarities, RNASEL, IL-6, IL-10, IL-1β and MMP7 have arisen as the most significant biomarkers in PCa treatment and management, having a potential clinical role. Validation prospective clinical studies are required to translate immunogenetics into precision treatment of PCa.
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Affiliation(s)
- Eva Dreussi
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Fabrizio Ecca
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Lucia Scarabel
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Sara Gagno
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
| | - Giuseppe Toffoli
- Department of Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, 33081, Italy
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