A Combination of Testosterone and White Blood Cell Count as a Predictive Factor of Overall Survival in Localized Prostate Cancer

Abstract

              <span> 
                </span><h3>Background</h3> 
                <p>It has been shown that neutrophil count or an elevated neutrophil-to-lymphocyte ratio (NLR) as well as testosterone levels are separately associated with increased mortality in patients with localized prostate cancer.</p> 

              <span> 
                </span><h3>Objective</h3> 
                <p>We tested a combination of testosterone levels and white blood cell (WBC) counts to predict overall survival (OS) in a prospective cohort of patients treated with radiotherapy for localized prostate cancer.</p> 

              <span> 
                </span><h3>Patients and Methods</h3> 
                <p>The 381 patients included in this study were prospectively enrolled in phase 2 or 3 studies. Multivariate Cox proportional hazards models were used to analyze the influence of WBC count and testosterone level on biochemical recurrence and OS. Cutoff levels of ≤10.4 nmol/L (300 ng/dL) for testosterone and a median value of 6.2 (×10<sup>9</sup>/L) for WBC count were used.</p> 

              <span> 
                </span><h3>Results</h3> 
                <p>The median follow-up for biochemical recurrence and OS were 72 and 78 months, respectively. A WBC count of ≥6.2 alone was not associated with OS (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.30–1.46). When combined with a testosterone level of &gt;10.3 nmol/L, a WBC count of ≥6.2 was associated with increased mortality (HR 2.96; 95% CI 1.45–6.06) when compared with a WBC count of &lt;6.2 (<em>p</em>-interaction = 0.01). The HR for biochemical recurrence for patients with a testosterone level &gt;10.3 nmol/L combined with a lymphocyte level above or equal to the median was nearly identical to the HR of a testosterone level &gt;10.3 nmol/L with a WBC above or equal to the median. There was no association between testosterone level and the NLR.</p> 

              <span> 
                </span><h3>Conclusions</h3> 
                <p>A high WBC and lymphocyte count combined with normal testosterone levels increases the overall mortality of patients treated with radiotherapy for localized prostate cancer within the first 6–7 years post-treatment. Validation in larger cohorts is necessary.<span> 
                    <span> 
                      <img alt="" src="http://ift.tt/2t1iDXD"/></span> 
                  </span> 
                       </p> 
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