Can blood counts predict the prognosis of metastatic prostate cancer?

This study investigated whether the neutrophil-to-lymphocyte ratio (NLR) can be used to predict clinical outcomes in metastatic prostate cancer. Researchers concluded that the NLR can help in determining clinical outcomes in metastatic prostate cancer.

Neutrophils are cells that are involved in inflammation (reaction to injury or infection). Lymphocytes are cells involved in the immune response. The neutrophil-to-lymphocyte ratio (NLR) can be easily calculated from routine blood tests. An elevated NLR has previously been associated with poor clinical outcomes in various malignant tumors. Whether NLR can predict clinical outcomes in metastatic (spread to other areas of the body) prostate cancer has not been fully studied. Predicting clinical outcomes is useful in determining appropriate treatment strategies early.

This study examined the records of 1,464 men with prostate cancer. 48 of these men had metastatic prostate cancer. Blood tests were performed on all men before any treatment was initiated. These measured the NLR and PSA levels (prostate-specific antigen, a protein present in prostate cancer). 87.5% of men with metastatic disease then underwent treatment with hormone therapy. 18.8% received bisphosphonates to treat bone damage. 7.1% of men underwent prostate surgery.

Blood test analysis from all men showed that there was an association between the NLR and PSA. Men with higher PSA levels had a significantly elevated NLR. 

The NLR was a strong predictor of survival among men with metastatic disease. Men with a high NLR showed significantly poorer overall survival (time from treatment until death from any cause) compared to men with a low NLR. The risk of mortality due to cancer was also increased in men with a high NLR.

Researchers concluded that the NLR is a strong predictor of clinical outcomes in metastatic prostate cancer.

Larger trials involving more men with metastatic disease are needed to confirm these preliminary results.