scholarly journals Prognostic value of lymphocyte cell ratios in peritoneal dialysis

2021 ◽  
Vol 35 (1) ◽  
pp. 18-21
Author(s):  
Roberto Marques ◽  
◽  
Eduarda Carias ◽  
Ana Domingos ◽  
Anabela Guedes ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Wide Spectrum ◽  
Laboratory Data ◽  
High Sensitivity ◽  
Residual Renal Function ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
Hs Crp

Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been introduced as useful inflammatory markers to predict the outcome of a wide spectrum of diseases, such as malignancies and cardiovascular pathologies. Limited evidence is available for their role in end-stage renal disease and dialysis patients. The aim of this study was to evaluate NLR and PLR as predictors of mortality in peritoneal dialysis (PD) patients. Methods: In this retrospective study 122 incident PD patients between 2004 and 2019 were included. Demographic, clinical and laboratory data were collected. Relationships between NLR, PLR and high-sensitivity C-reactive protein (hs-CRP) were evaluated by Spearman correlation test. Univariable and multivariable Cox regression analysis were performed to determine the association of NLR and PLR with all-cause mortality. Results: Mean levels of NLR and PLR were 3.99±2.6 and 195.5±101.7, respectively. Both NLR and PLR were significantly and positively correlated with serum hs-CRP levels (r=0.340, p<0.001 and r=0.360, p<0.001, respectively). The overall mortality rate was 18.9% after a mean follow-up of 30.2±24.0 months. On multivariable modeling, we found that higher NLR (HR=1.662, 95%CI 1.117-2.472) and higher PLR (HR=1.010, 95%CI 1.004-1.015), in addition to lower residual renal function and higher Charlson comorbidity index were significant independent predictors of poor survival, when adjusted for nutritional status. Discussion: In this study, NLR and PLR were validated as inflammatory markers and predicted survival in our PD patients. Our results suggest that NLR might be a better indicator of mortality than PLR.

scholarly journals Neutrophil to Lymphocyte Ratio Predicts Adverse Cardiovascular Outcome in Peritoneal Dialysis Patients Younger than 60 Years Old

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yingsi Zeng ◽  
Zijun Chen ◽  
Qinkai Chen ◽  
Xiaojiang Zhan ◽  
Haibo Long ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cox Regression ◽  
Neutrophil To Lymphocyte Ratio ◽  
Forest Plot ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
The Relationship ◽  
Cvd Mortality ◽  
New Onset

Background. Neutrophil to lymphocyte ratio (NLR) is a new inflammatory marker; the relationship between NLR and adverse cardiovascular (CV) prognosis has been gradually emphasized in the general population. However, their association in peritoneal dialysis (PD) patients remains unclear. Methods. From January 1, 2010, to May 31, 2017, a total of 1652 patients were recruited. NLR was categorized in triplicates: NLR≤2.74, 2.74<NLR≤3.96, and NLR>3.96. Kaplan-Meier cumulative incidence curve and multivariable COX regression analysis were used to determine the relationship between NLR and the incidence of adverse CV outcome, while a competitive risk model was applied to assess the effects of other outcomes on adverse CV prognosis. Besides, forest plot was investigated to analyze the adverse CV prognosis in different subgroups. Results. During follow-up, 213 new-onset CV events and 153 CV disease (CVD) deaths were recorded. Multivariable COX regression models showed that the highest tertile of NLR level was associated with increased risk of CV events (HR=1.39, 95%CI=1.01‐1.93, P=0.046) and CVD mortality (HR=1.81, 95%CI=1.22‐2.69, P=0.003), while compared to the lowest tertile. Competitive risk models showed that the differences in CV event (P<0.001) and CVD mortality (P=0.004) among different NLR groups were still significant while excluding the effects of other outcomes. In subgroups, with each 1 increased in the NLR level, adjusted HR of new-onset CV event was 2.02 (95%CI=1.26−3.23, P=0.003) and CVD mortality was 2.98 (95%CI=1.58−5.62, P=0.001) in the younger group (age<60 years). Conclusions. NLR is an independent risk factor for adverse CV prognosis in PD patients younger than 60 years old.

scholarly journals An Inverse Relationship between Hyperuricemia and Mortality in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2018 ◽  
Vol 7 (11) ◽  
pp. 416 ◽  
Author(s):  
Kuan-Ju Lai ◽  
Chew-Teng Kor ◽  
Yao-Peng Hsieh
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cox Regression ◽  
Laboratory Data ◽  
Study Cohort ◽  
Dialysis Unit ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Adjusted Model ◽  
The Impact

Background: The results have been inconsistent with regards to the impact of uric acid (UA) on clinical outcomes both in the general population and in patients with chronic kidney disease. The aim of this study was to study the influence of serum UA levels on mortality in patients undergoing continuous ambulatory peritoneal dialysis. Methods: Data on 492 patients from a single peritoneal dialysis unit were retrospectively analyzed. The mean age of the patients was 53.5 ± 15.3 years, with 52% being female (n = 255). The concomitant comorbidities at the start of continuous ambulatory peritoneal dialysis (CAPD) encompassed diabetes mellitus (n = 179, 34.6%), hypertension (n = 419, 85.2%), and cardiovascular disease (n = 186, 37.9%). The study cohort was divided into sex-specific tertiles according to baseline UA level. A Cox proportional hazard model was used to calculate hazard ratios (HRs) of all-cause, cardiovascular, and infection-associated mortality with adjustments for demographic and laboratory data, medications, and comorbidities. Results: Multivariate Cox regression analysis showed that, using UA tertile 1 as the reference, the adjusted HR of all-cause, cardiovascular, and infection-associated mortality for tertile 3 was 0.4 (95% confidence interval (CI) 0.24–0.68, p = 0.001), 0.4 (95% CI 0.2–0.81, p = 0.01), and 0.47 (95% CI 0.19–1.08, p = 0.1). In the fully adjusted model, the adjusted HRs of all-cause, cardiovascular, and infection-associated mortality for each 1-mg/dL increase in UA level were 0.84 (95% CI, 0.69–0.9, p = 0.07), 0.79 (95% CI, 0.61–1.01, p = 0.06), and 0.79 (95% CI, 0.48–1.21, p = 0.32) for men and 0.57 (95% CI, 0.44–0.73, p < 0.001), 0.6 (95% CI, 0.41–0.87, p = 0.006), and 0.41 (95% CI, 0.26–0.6, p < 0.001) for women, respectively. Conclusions: Higher UA levels are associated with lower risks of all-cause, cardiovascular and infection-associated mortality in women treated with continuous ambulatory peritoneal dialysis.

scholarly journals Prognostic role of inflammatory markers in hepatocellular cancer patients receiving sorafenib therapy

2020 ◽  
Vol 7 (5) ◽  
pp. 475-481
Author(s):  
Ali Oğul ◽  
Mahmut Büyükşimşek
Keyword(s):  
Inflammatory Markers ◽  
Prognostic Value ◽  
Cox Regression ◽  
Hepatocellular Cancer ◽  
Prognostic Role ◽  
Sorafenib Treatment ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
Tumor Focus

Objective: Systemic inflammatory markers have been shown to have prognostic value in many types of cancers. Although the prognostic role of the systemic immune-inflammation index (SII), derived neutrophil-lymphocyte ratio (dNLR) and platelet lymphocyte ratio (PLR) has been shown in hepatocellular cancer (HCC) patients who underwent transplantation, its prognostic value has not been investigated in HCC patients under sorafenib treatment. We investigated the prognostic value of inflammatory indices in patients with HCC under sorafenib treatment. Materials and Methods: The data of 46 patients with stage III unresectable and stage IV HCC were evaluated retrospectively. SII and dNLR were dichotomized based on receiver operating characteristic (ROC) curve analysis (cut-off values: 355 and 1.8). No cut-off value could be determined for PLR; therefore, the median value was defined as the cut-off for PLR. At the time of diagnosis, values of these three inflammatory markers were analyzed to determine their association with clinicopathologic characteristics and to assess their prognostic values via the Kaplan-Meier method and multivariate Cox regression analysis. Results: Overall survival (OS) was significantly shorter in patients with a high SII, dNLR, or PLR. In univariate analyses, tumor stage, tumor focus count, and presence of extrahepatic lesions seemed to affect survival. Multivariate analysis revealed SII and the presence of extrahepatic lesions as independent risk factors for survival. Conclusion: The findings of the present study suggest that a high SII is an independent risk factor for survival in patients with HCC under sorafenib treatment.

scholarly journals MO688CALCIUM PHOSPHATE PRODUCT IN PERITONEAL DIALYSIS: A RISK FACTOR FOR TYPE I MEMBRANE FAILURE?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Berfu Korucu ◽  
Omer Faruk Akcay ◽  
Galip Guz
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
High Glucose ◽  
Cox Regression ◽  
Residual Renal Function ◽  
Study Endpoint ◽  
Type I ◽  
Cox Regression Analysis ◽  
Increased Risk

Abstract Background and Aims Type I membrane failure (T1MF), increased transport status with ultrafiltration, and solute removal inadequacy are among the most challenging issues in peritoneal dialysis (PD) continuity. Although quite common, the causes of T1MF are not fully understood. This study aims to identify risk factors associated with T1MF. Method This is a retrospective, single site, cohort study of incident adult peritoneal dialysis patients sampled between January 2000 and January 2020. Patients were classified as “increased transporters” who had two or more categories of a rise in peritoneal equilibration test (PET), and “stable transporters” who had had a rise of 1 or no categories from their baseline during follow-up. The four-hour dialysate/plasma creatinine ratio was used to classify PET categories. The study endpoint was five years for stable transporters, and at the time of two category rise in the PET test for increased transporters. Results Baseline demographics, diabetes frequency, residual renal function (RRF), non-phosphate baseline laboratory, parathormone levels, and PD modalities were similar between the increased transporters (n=48) and the stable transporters (n=93). Significantly more patients were using renin-angiotensin-aldosterone system (RAAS) blockers in stable transporters and high-glucose dialysates in increased transporters (p=0.03 and p&lt;0.01). Icodextrin, calcitriol, calcium-based phosphate binder use, and the number of peritonitis episodes were similar between the groups. Increased transporters reached the endpoint in 3.9(±0.7) years. Increased transporters had a higher baseline phosphate than stable transporters (p=0.02). The frequency of patients with an RRF and groups’ mean RRF in ml were similar at the endpoint (p=0.37, p=0.13). Increased transporters had a significantly higher baseline and endpoint CaXP than stable transporters (p&lt;0.01 and p=0.02). Baseline weekly peritoneal Kt/V and peritoneal creatinine clearance (PCrCl) were similar at baseline. Increased transporters had significantly lower endpoint peritoneal Kt/V and insignificantly lower endpoint PCrCl than stable transporters (p&lt;0.01 and p=0.05). ΔUF was negative for increased transporters and positive for stable transporters. Age, diabetes, peritonitis episodes, RAAS blocker use, and PD modality were insignificant in Cox regression analysis. A CaXP of &gt;55 was related to 2.51-fold, and high-glucose dialysates were associated with a 2.93-fold increased risk for a rise in transport status (p=0.01 and p&lt;0.01). Mean follow-up was 7.0 (±3.9) years for stable transporters and 5.6 (±2.0) years for increased transporters. Technical survival was significantly higher in stable transporters (p=0.03). Conclusion Our study revealed a CaXP of &gt;55 is a risk factor for a significant increase in transport status, presumably due to peritoneal calcification. The peritoneal Kt/V, PCrCl, and UF rates declined accordingly. The high-glucose dialysates are associated with a high risk in analyses. However, it is not possible to determine whether these solutions are the cause or the result of Type I membrane failure.

The Effect of Depressive Symptoms on Survival in Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (3) ◽  
pp. 256-263 ◽  
Author(s):  
Rebecca Einwohner ◽  
Judith Bernardini ◽  
Linda Fried ◽  
Beth Piraino
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Depressive Symptoms ◽  
Serum Albumin ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Residual Renal Function ◽  
Dialysis Patients ◽  
Single Measurement ◽  
Cox Regression Analysis

Objective There is little information on the relationship between depressive symptoms and survival in peritoneal dialysis (PD) patients. We examined whether a single measurement of depressive symptoms using a simple self-administered tool predicts survival. Design Screening test of depressive symptoms as a predictor of outcome. Setting Three dialysis centers in Southwestern Pennsylvania. Participants 66 adult PD subjects were screened in 1997–1998 for depression using the Zung scale. Main Outcome Measures Baseline data collection included assessments of comorbidity, residual renal function, total Kt/V, nPNA, previous renal transplant, and serum albumin. Outcomes were collected prospectively after completion of the depression survey to 12/01. Cox regression analysis of patient survival was performed using all cofactors with p < 0.05 on univariate analysis. Results One third of patients had depressive symptoms. Compared to nondepressed patients, depressive symptom patients were older (62.5 vs 52.5 years, p = 0.012), had borderline lower serum albumin levels (3.47 vs 3.70 g/dL, p = 0.058), and were more disabled (Karnofsky score 70 vs 90, p < 0.001), but had similar Kt/V, residual renal function, and previous time on PD at the point of the testing. Using multivariate analysis and controlling for comorbidity (using a measurement that includes diabetes mellitus and age) and serum albumin, the survival of patients with depressive symptoms was significantly reduced compared to nondepressed patients. Conclusion A single measurement of depressive symptoms using a simple self-administered test was an independent predictor of death in a cohort of PD patients, which extends observations in hemodialysis patients. Screening for depressive symptoms should be routine for dialysis patients, and those depressed should have thorough assessment and treatment. Whether treating depression will have an impact on survival is unclear and needs to be studied.

Abstract 12140: Prognostic Value of Multiple Biomarkers on Mortality in Adults Congenital Heart Disease: Comparison of Single- and Two-Ventricle Physiology

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kenji Miyamoto ◽  
Daiji Takeuchi ◽  
Kei Inai ◽  
Tokuko Shinohara ◽  
Toshio Nakanishi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cox Regression ◽  
High Sensitivity ◽  
Cardiovascular Death ◽  
Blood Levels ◽  
Type I ◽  
Cox Regression Analysis ◽  
Hs Crp

Introduction: Although many biomarkers are associated with heart failure, limited data is available on their prognostic predictive value in adults with congenital heart disease (ACHD). We investigate the potential of various biomarkers to predict ACHD mortality. Methods and Results: This is a single-center, retrospective cohort study. Blood levels of neurohormones (endothelin-1 [ET1], norepinephrine [NE], aldosterone, and plasma renin activity [PRA]); inflammatory biomarkers (high sensitivity C-reactive protein [hs-CRP], high sensitivity tumor necrosis factor [hs-TNF]-α, soluble TNF receptor type I and II [sTNF-RI and sTNF-RII], and interleukin-6 [IL-6]); and brain natriuretic peptide (BNP) were measured in 115 ACHD (mean age, 30 ± 10 years). NYHA class was I/ II in 86% and III/IV in 14%. The subjects were divided into two groups: patients with single-ventricle (SV group, n = 65) and with two-ventricle physiology (TV group, n = 50). We retrospectively analyzed the relationship between levels of biomarkers and cardiovascular death. During a mean follow-up period of 4.6 years, 17 (14%) cardiovascular deaths occurred, including 7 in the SV group. Univariate cox regression analysis in all subjects showed strong association between elevated levels of ET1, NE, RPA, hs-CRP, sTNF-RI and II, IL-6, and BNP and cardiovascular death (p< 0.05). In the SV group, using multivariate cox regression model, BNP and sTNF-RI were the most powerful predictors in these biomarkers (adjusted hazard ratio [aHR] of BNP: 14.84; 95%CI: 2.21-99.36 per 1 SD increase, p = 0.005) (aHR of sTNF-RI: 2.30; 95%CI: 1.91-4.55 per 1 SD increase, p = 0.017). The optimal cut-off values of BNP and sTNF-RI for mortality were 196 pg/mL and 1.26 ng/mL, respectively. Conversely, in the TV group, only IL-6 was an independent predictor of mortality (aHR: 3.24; 95%CI: 1.57-6.68 per 1 SD increase, p = 0.001), while BNP was not strongly associated with outcomes. The optimal cut-off value of IL-6 for mortality was 2.3 pg/mL. Conclusion: Various biomarkers, including sTNF-R, BNP, and IL-6, are associated with prognosis in overall ACHD. The most prominent mortality predictors might differ, due to differences in SV or TV physiology.

scholarly journals Preoperative inflammatory markers of NLR and PLR as indicators of poor prognosis in resectable HCC

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7132 ◽  
Author(s):  
Dong Wang ◽  
Ning Bai ◽  
Xi Hu ◽  
Xi Wu OuYang ◽  
Lei Yao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Resection ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Cancer Prognosis ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
Kaplan Meier ◽  
Tumor Number ◽  
Cell Propagation

Background Many recent studies have demonstrated the predominant role chronic inflammation plays in cancer cell propagation, angiogenesis and immunosuppression. Cancer-related inflammation (CRI) has been shown to correlate with poor cancer prognosis. Our study aimed to evaluate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with hepatocellular carcinoma (HCC) who have undergone liver resection. Methods Between 2012 and 2015, 239 patients with HCC who had undergone liver resection at XiangYa Hospital Central South University were included in this study. The values of simple inflammatory markers, including the NLR and PLR, used in predicting the long-term outcomes of these patients were evaluated using Kaplan–Meier curves and Cox regression models. Results The cutoff values of the NLR and PLR were 2.92 and 128.1, respectively. In multivariate Cox regression analysis, high NLR (≥2.92) and high PLR (≥128.1) were independent risk factors predicting poorer outcomes in patients with HCC. However, high NLR and high PLR were prognostic factors in tumor size and tumor number. Conclusions In this study, we identified that high NLR (≥2.92) and high PLR (≥128.1) are useful prognostic factors in predicting outcomes in patients with HCC whom underwent liver resection.

scholarly journals High-Sensitivity C-Reactive Protein is a Predictor of Subsequent Atrial High-Rate Episodes in Patients with Pacemakers and Preserved Ejection Fraction

2020 ◽  
Vol 9 (11) ◽  
pp. 3677
Author(s):  
Min-Tsun Liao ◽  
Chun-Kai Chen ◽  
Ting-Tse Lin ◽  
Li-Ying Cheng ◽  
Hung-Wen Ting ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
High Rate ◽  
C Reactive Protein ◽  
Cox Regression Analysis ◽  
Reactive Protein ◽  
Increased Risk ◽  
Hs Crp

Atrial fibrillation (AF) is associated with morbidity and mortality. Modern pacemakers can detect atrial high-rate episodes (AHREs) as a surrogate for AF. It remains controversial whether inflammation is a cause or a consequence of AF. This study investigated whether the inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) can predict subsequent AHREs. This study gathered prospective data from patients with pacemakers and a left ventricle EF ≥ 50% between 2015 and 2019. The hs-CRP and other cardiac biomarkers at baseline and device-detected AHREs, defined as atrial rate ≥ 180 bpm and duration ≥ 6 min, were determined. Cox regression analysis was used to estimate the independent predictors for AHREs. A total of 171 consecutive patients were included. During the median follow-up of 614 days, 66 patients (39%) developed subsequent AHREs. In the univariate Cox regression analysis, sick sinus syndrome (p = 0.005), prior AF (p < 0.001), mitral A velocity (p = 0.008), and hs-CRP (p = 0.013) showed significant association with the increased risk of AHREs. In the multivariate Cox regression model, hs-CRP (HR = 1.121, 95% confidence interval = 1.015–1.238, p = 0.024) retained its significance. Our results suggest that elevated hs-CRP could predict subsequent AHREs and that inflammation could play a role in AF pathogenesis in patients with preserved EF.

scholarly journals The prognostic and diagnostic significance of the neutrophil-to-lymphocyte ratio in hepatocellular carcinoma: a prospective controlled study

2021 ◽  
Author(s):  
Philip J. Johnson ◽  
Sofi Dhanaraj ◽  
Sarah Berhane ◽  
Laura Bonnett ◽  
Yuk Ting Ma
Keyword(s):  
Hepatocellular Carcinoma ◽  
Regression Analysis ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Prognostic Models ◽  
Controlled Study ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference

Abstract Background The neutrophil–lymphocyte ratio (NLR), a presumed measure of the balance between neutrophil-associated pro-tumour inflammation and lymphocyte-dependent antitumour immune function, has been suggested as a prognostic factor for several cancers, including hepatocellular carcinoma (HCC). Methods In this study, a prospectively accrued cohort of 781 patients (493 HCC and 288 chronic liver disease (CLD) without HCC) were followed-up for more than 6 years. NLR levels between HCC and CLD patients were compared, and the effect of baseline NLR on overall survival amongst HCC patients was assessed via multivariable Cox regression analysis. Results On entry into the study (‘baseline’), there was no clinically significant difference in the NLR values between CLD and HCC patients. Amongst HCC patients, NLR levels closest to last visit/death were significantly higher compared to baseline. Multivariable Cox regression analysis showed that NLR was an independent prognostic factor, even after adjustment for the HCC stage. Conclusion NLR is a significant independent factor influencing survival in HCC patients, hence offering an additional dimension in prognostic models.

scholarly journals Prognostic Association between Common Laboratory Tests and Overall Survival in Elderly Men with De Novo Metastatic Castration Sensitive Prostate Cancer: A Population-Based Study in Canada

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2844
Author(s):  
Christopher J. D. Wallis ◽  
Bobby Shayegan ◽  
Scott C. Morgan ◽  
Robert J. Hamilton ◽  
Ilias Cagiannos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Clinical Decision Making ◽  
Cox Regression ◽  
De Novo ◽  
Population Based ◽  
Population Based Study ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
Laboratory Markers

De novo cases of metastatic prostate cancer (mCSPC) are associated with poorer prognosis. To assist in clinical decision-making, we aimed to determine the prognostic utility of commonly available laboratory-based markers with overall survival (OS). In a retrospective population-based study, a cohort of 3556 men aged ≥66 years diagnosed with de novo mCSPC between 2014 and 2019 was identified in Ontario (Canada) administrative database. OS was assessed by using the Kaplan–Meier method. Multivariate Cox regression analysis was performed to evaluate the association between laboratory markers and OS adjusting for patient and disease characteristics. Laboratory markers that were assessed include neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), albumin, hemoglobin, serum testosterone and PSA kinetics. Among the 3556 older men with de novo mCSPC, their median age was 77 years (IQR: 71–83). The median survival was 18 months (IQR: 10–31). In multivariate analysis, a statistically significant association with OS was observed with all the markers (NLR, PLR, albumin, hemoglobin, PSA decrease, reaching PSA nadir and a 50% PSA decline), except for testosterone levels. Our findings support the use of markers of systemic inflammation (NLR, PLR and albumin), hemoglobin and PSA metrics as prognostic indicators for OS in de novo mCSPC.

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