Predictive Value of Platelet-to-Lymphocyte Ratio and Systemic Immune‐Inflammation Index in Adverse Pathology at Radical Prostatectomy in Patients with Low-Grade Prostate Cancer

Purpose: To determine the potential role of several biochemical and clinical markers in predicting adverse pathology (AP) and ISUP GG upgrading at radical prostatectomy (RP) with low-grade (ISUP Gleason Group (ISUP GG) 1 and 2) prostate cancer (PCa). Methods: We retrospectively reviewed the patients who underwent radical prostatectomy following criteria: clinical stage T2a or less,and were identified low-grade PCa (ISUP GG 1−2, prostate-specifific antigen (PSA) <20 ng/ml) through prostate biopsy, univariate and multivariate analyses were performed to evaluate the association of patient and tumor characteristics with reclassification, defined as defined as stage ≥T3 and/or ISUP GG ≥3. Results: A total of 155 patients were eligible for this study. AP at RP occurred in 20 of 97 (20.62%) patients with ISUP GG 1, and 28 of 58 (48.28%) with ISUP GG 2. At univariate analysis, bioptic ISUP GG emerged as significant risk factors of AP(p＜0.001). platelets to lymphocyte ratio(PLR) might be the risk factor of AP(p=0.059). At multivariate analysis, we found PLR and bioptic ISUP GG kept statistical significance. The area under the curve for PLR was 0.592. Multivariate analyses showed that systemic immune inflammation index(SII), and bioptic ISUP GG were significantly associated with ISUP GG upgrading (ORs ranging from 0.453 to 0.999) showing a protective effect. Conclusions: We found that SII could not be a significant risk factor of AP at low-grade prostate cancer (PCa) after RP. PLR might be used as an independent predictor which was inversely correlated with presence of AP in low-grade PCa after RP. While SII might be a predict factor for ISUP GG upgrading in low-grade PCa.