NEW ORLEANS—An elevated neutrophil-lymphocyte ratio (NLR) prior to radical prostatectomy for prostate cancer is significantly associated with higher rates of biochemical recurrence and positive surgical margins, data presented at the American Urological Association annual meeting suggest.

Compared with patients who have an NLR below 5, those with an NLR above 5 have a significant 13% increased risk of biochemical recurrence at 10 years.

Vidit Sharma, MD, of Mayo Clinic in Rochester, Minn., and colleagues identified 8,350 RP patients who had a median follow-up of 9.7 years. Of these, 1,568 (18.7%) had a pre-RP NLR above 5. These patients were significantly more likely than those with an NLR below 5 to have pT3/4 disease at RP (22% vs. 17.1%) and positive surgical margins (33.2% vs. 25.8%) and significantly more likely to receive adjuvant hormonal therapy (13.8% vs. 8.2%) and radiation therapy (4.7% vs. 3.2%).

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Patients with an NLR above 5 also were significantly more likely to receive salvage hormonal therapy during follow-up (14% vs. 11.4%). After controlling for age, Gleason score, preoperative PSA level, pathologic state, and use of adjuvant hormonal or radiation therapy, an NLR above 5 remained a significant predictor of biochemical recurrence, according to investigators.

An elevated NLR is a marker of systemic inflammation that is associated with adverse outcomes in multiple malignancies.