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Cancer Causes Control. 2018 Jun;29(6):581-588. doi: 10.1007/s10552-018-1031-2. Epub 2018 Apr 17.

Neutrophil, lymphocyte and platelet counts, and risk of prostate cancer outcomes in white and black men: results from the SEARCH database.

Author information

1
Department of Surgery, Division of Urology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
2
Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
3
Surgery Section, Durham VA Medical Center, Durham, NC, 27710, USA.
4
Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, 94115, USA.
5
Urology Department, University of California San Diego Health System, San Diego, CA, 92093, USA.
6
Urology Section, Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, 90073, USA.
7
Department of Urology, UCLA School of Medicine, Los Angeles, CA, 90095, USA.
8
Section of Urology, Veterans Affairs Medical Center, Augusta, GA, 30904, USA.
9
Department of Surgery, Section of Urology, Medical College of Georgia, Augusta, GA, 30912, USA.
10
Department of Urology, Oregon Health and Science University Hospital, Portland, OR, 97239, USA.
11
Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
12
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
13
Department of Surgery, Division of Urology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA. Stephen.Freedland@cshs.org.
14
Surgery Section, Durham VA Medical Center, Durham, NC, 27710, USA. Stephen.Freedland@cshs.org.
15
Division of Urology, Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8631 West 3rd Street Suite 430W, Los Angeles, CA, 90048, USA. Stephen.Freedland@cshs.org.

Abstract

PURPOSE:

Systemic inflammation, as measured by C-reactive protein, has been linked with poor prostate cancer (PC) outcomes, predominantly in white men. Whether other immune measures like white blood cell counts are correlated with PC progression and whether results vary by race is unknown. We examined whether complete blood count (CBC) parameters were associated with PC outcomes and whether these associations varied by race.

METHODS:

Analyses include 1,826 radical prostatectomy patients from six VA hospitals followed through medical record review for biochemical recurrence (BCR). Secondary outcomes included castration-resistant PC (CRPC), metastasis, all-cause mortality (ACM), and PC-specific mortality (PCSM). Cox-proportional hazards were used to assess the associations between pre-operative neutrophils, lymphocytes, platelets, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) with each outcome. We used a Bonferroni-corrected p-value of 0.05/5 = 0.01 as the threshold for statistical significance.

RESULTS:

Of 1,826 men, 794 (43%) were black and 1,032 (57%) white. Neutrophil count (p < 0.001), NLR (p < 0.001), and PLR (p < 0.001) were significantly lower, while lymphocyte count (p < 0.001) was significantly higher in black versus white men. After adjusting for clinicopathological features, no CBC measures were significantly associated with BCR. There were no interactions between CBC and race in predicting BCR. Similarly, no CBC values were significantly associated with CRPC, metastases, or PCSM either among all men or when stratified by race. However, higher neutrophil count was associated with higher ACM risk in white men (p = 0.004).

CONCLUSION:

Pre-operative CBC measures were not associated with PC outcomes in black or white men undergoing radical prostatectomy, except for neutrophils-positive association with risk of ACM in white men. Whether circulating immune cell markers provide insight to the pathophysiology of PC progression or adverse treatment outcomes requires further study.

KEYWORDS:

CBC; Prostate cancer; Radical prostatectomy

PMID:
29663110
PMCID:
PMC5940530
[Available on 2019-06-01]
DOI:
10.1007/s10552-018-1031-2

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