Research Papers:

The prognostic significance of postoperative neutrophil-to-lymphocyte ratio after radical prostatectomy for localized prostate cancer

Won Sik Jang, Kang Su Cho, Myung Soo Kim, Cheol Yong Yoon, Dong Hyuk Kang, Yong Jin Kang, Won Sik Jeong, Won Sik Ham and Young Deuk Choi _

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Oncotarget. 2017; 8:11778-11787. https://doi.org/10.18632/oncotarget.14349

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Won Sik Jang1, Kang Su Cho1, Myung Soo Kim1, Cheol Yong Yoon1, Dong Hyuk Kang1, Yong Jin Kang1, Won Sik Jeong1, Won Sik Ham1, Young Deuk Choi1

1Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea

Correspondence to:

Young Deuk Choi, email: [email protected]

Won Sik Jang, email: [email protected]

Keywords: neutrophil-to-lymphocyte ratio, prostate cancer, radical prostatectomy, biochemical recurrence, survival

Received: September 06, 2016     Accepted: December 15, 2016     Published: December 29, 2016


Background: The pretreatment neutrophil-to-lymphocyte ratio has prognostic value after radical prostatectomy for treating localized prostate cancer. However, the use of postoperative neutrophil-to-lymphocyte ratio has not been evaluated in this population. We investigated the prognostic significance of early postoperative neutrophil-to-lymphocyte ratio after radical prostatectomy for prostate cancer.

Methods: We retrospectively reviewed clinical data from 2,302 patients with localized prostate cancer who underwent radical prostatectomy at our institution between years 2000 and 2010. Only patients with pre- and postoperative complete blood counts with differential results were included. Patients who received neoadjuvant or postoperative adjuvant treatment and those without adequate medical records were excluded. Kaplan-Meier analyses were performed to analyze biochemical recurrence-free survival and overall survival rates. Univariate and multivariate Cox regression models were used for each endpoint.

Results: Kaplan-Meier curves showed that high postoperative neutrophil-to-lymphocyte ratio (>3.5) was significantly associated with decreased biochemical recurrence-free survival (p = 0.009) and overall survival (p = 0.010). In the univariate and multivariate Cox regression analyses, high postoperative neutrophil-to-lymphocyte ratio was a significant predictor of biochemical recurrence (hazard ratio 1.270, p = 0.008) and overall survival (hazard ratio 1.437, p = 0.033).

Conclusions: Our results demonstrate that postoperative neutrophil-to-lymphocyte ratio is an independent factor for biochemical recurrence and overall survival in patients who underwent radical prostatectomy for prostate cancer. These findings suggest that neutrophil-to-lymphocyte ratio can be a potentially valuable tool for stratifying high-risk patients and facilitating choices of postoperative therapy in patients with prostate cancer.

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