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Int. J. Mol. Sci. 2017, 18(2), 380; doi:10.3390/ijms18020380

The Role of the Neutrophil to Lymphocyte Ratio for Survival Outcomes in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Abiraterone

1
Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany
2
Department of Nuclear Medicine, Muenster University Medical Center, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany
3
Department of Rheumatology, Dresden University Medical Center, Fetscherstraße 74, D-01307 Dresden, Germany
4
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110, USA
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Carsten Stephan
Received: 26 November 2016 / Revised: 29 January 2017 / Accepted: 7 February 2017 / Published: 11 February 2017
(This article belongs to the Special Issue Diagnostic, Prognostic and Predictive Biomarkers in Prostate Cancer)
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Abstract

The purpose of this study was to examine the prognostic capability of baseline neutrophil-to-lymphocyte-ratio (NLR) and NLR-change under Abiraterone in metastatic castration-resistant prostate cancer patients. The impact of baseline NLR and change after eight weeks of treatment on progression-free survival (PFS) and overall survival (OS) was analyzed using Kaplan-Meier-estimates and Cox-regression. 79 men with baseline NLR <5 and 17 with NLR >5 were analyzed. In baseline analysis of PFS NLR >5 was associated with non-significantly shorter median PFS (five versus 10 months) (HR: 1.6 (95%CI:0.9–2.8); p = 0.11). After multivariate adjustment (MVA), ECOG > 0–1, baseline LDH>upper limit of normal (UNL) and presence of visceral metastases were independent prognosticators. For OS, NLR >5 was associated with shorter survival (seven versus 19 months) (HR: 2.3 (95%CI:1.3–4.0); p < 0.01). In MVA, ECOG > 0–1 and baseline LDH > UNL remained independent prognosticators. After 8 weeks of Abiraterone NLR-change to <5 prognosticated worse PFS (five versus 12 months) (HR: 4.1 (95%CI:1.1–15.8); p = 0.04). MVA showed a trend towards worse PFS for NLR-change to <5 (p = 0.11). NLR-change to <5 led to non-significant shorter median OS (seven versus 16 months) (HR: 2.3 (95%CI:0.7–7.1); p = 0.15). MVA showed non-significant difference for OS. We concluded baseline NLR <5 is associated with improved survival. In contrast, in patients with baseline NLR >5, NLR-change to <5 after eight weeks of Abiraterone was associated with worse survival and should be interpreted carefully. View Full-Text
Keywords: neutrophil-to-lymphocyte ratio; castration-resistant prostate cancer; prognostic biomarker; treatment response; abiraterone neutrophil-to-lymphocyte ratio; castration-resistant prostate cancer; prognostic biomarker; treatment response; abiraterone
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MDPI and ACS Style

Boegemann, M.; Schlack, K.; Thomes, S.; Steinestel, J.; Rahbar, K.; Semjonow, A.; Schrader, A.J.; Aringer, M.; Krabbe, L.-M. The Role of the Neutrophil to Lymphocyte Ratio for Survival Outcomes in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Abiraterone. Int. J. Mol. Sci. 2017, 18, 380.

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