title: Neutrophil count is associated with survival in localized prostate cancer.
abstract: BACKGROUND
  Increasing evidence suggests a close relationship between systemic inflammation and cancer development and progression. The neutrophil to lymphocyte ratio (NLR) has been shown to be an independent prognostic indicator in various advanced and localized cancers. We investigated the influence of markers of systemic inflammation such as leucocyte counts and metabolic co-morbidities on overall survival (OS) after radiotherapy for localized prostate cancer.
  
  
  METHODS
  We conducted a retrospective study of patients with localized prostate cancer treated with definitive external beam radiotherapy or brachytherapy. Univariate and multivariate cox proportional hazards models were used to investigate the influence of the following factors on OS: age, neutrophil and lymphocyte counts, neutrophil-to-lymphocyte ratio (NLR), Cancer of the Prostate Risk Assessment (CAPRA) score as well as comorbidities associated with inflammation such as cardiac history, diabetes and use of a statin. A stepwise selection of variable based on the Akaike information criterion (AIC) was used for multivariate analysis.
  
  
  RESULTS
  In total, 1772 pts were included; blood count data was available for 950 pts. Median age was 68 years (44-87). Actuarial 5 years OS and biochemical recurrence-free survival (BRFS) for the 1772 patients were 93% and 95%, respectively, with a median follow-up of 44 months (1-156). On univariate analysis, neutrophil count (p = 0.04), cardiac history (p = 0.008), age (p = 0.001) and CAPRA (p = 0.0002) were associated with OS. Lymphocytes, NLR and comorbidities other than cardiac history were not associated with mortality. On multivariate analysis, neutrophil count (HR = 1.18, 95 % CI: 1.017-1.37, p = 0.028), age (HR = 1.06, 95 % CI: 1.01-1.1, p = 0.008) and CAPRA (HR = 1.16, 95 % CI: 1.03-1.31, p = 0.015) were independent predictors of OS.
  
  
  CONCLUSIONS
  Neutrophil count, as a possible marker of systemic inflammation, appear to be an independent prognostic factor for overall mortality in localized prostate cancer. A validation cohort is needed to corroborate these results.
authors: Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada. houda.bahig@umontreal.ca.
authors: Houda
authors: H
authors: Bahig
authors: Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada. daniel.taussky.chum@ssss.gouv.qc.ca.|CRCHUM-Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada. daniel.taussky.chum@ssss.gouv.qc.ca.
authors: Daniel
authors: D
authors: Taussky
authors: Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada. guila.delouya.chum@ssss.gouv.qc.ca.|CRCHUM-Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada. guila.delouya.chum@ssss.gouv.qc.ca.
authors: Guila
authors: G
authors: Delouya
authors: Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada. amalnadiri@gmail.com.|CRCHUM-Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada. amalnadiri@gmail.com.
authors: Amal
authors: A
authors: Nadiri
authors: Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada. arianegagnonjacques@msn.com.
authors: Ariane
authors: A
authors: Gagnon-Jacques
authors: CRCHUM-Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada. bodson.paule@gmail.com.
authors: Paule
authors: P
authors: Bodson-Clermont
authors: Medical Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada. Denis.Soulieres.chum@ssss.gouv.qc.ca.
authors: Denis
authors: D
authors: Soulieres
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome