Assessment of PSIM (Prostatic Systemic InflammatoryMarkers) Score in Predicting Pathologic Features at Robotic Radical Prostatectomy in Patients with Low-Risk ProstateCancer Who Met the Inclusion Criteria for Active Surveillance

• Main Authors: Matteo Ferro, Gennaro Musi, Deliu Victor Matei, Alessandro Francesco Mistretta, Stefano Luzzago, Gabriele Cozzi, Roberto Bianchi, Ettore Di Trapani, Antonio Cioffi, Giuseppe Lucarelli, Gian Maria Busetto, Francesco Del Giudice, Giorgio Ivan Russo, Marina Di Mauro, Angelo Porreca, Giuseppe Renne, Michele Catellani, Danilo Bottero, Antonio Brescia, Giovanni Cordima, Ottavio de Cobelli
• Format: Article
• Language: English
• Published: MDPI AG 2021-02-01
• Series: Diagnostics
• Subjects: prostate cancer; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio; lymphocyte to monocyte ratio; prognosis; active surveillance
• Online Access: https://www.mdpi.com/2075-4418/11/2/355

Background: circulating levels of lymphocytes, platelets and neutrophils have been identified as factors related to unfavorable clinical outcome for many solid tumors. The aim of this cohort study is to evaluate and validate the use of the Prostatic Systemic Inflammatory Markers (PSIM) score in predicting and improving the detection of clinically significant prostate cancer (csPCa) in men undergoing robotic radical prostatectomy for low-risk prostate cancer who met the inclusion criteria for active surveillance. Methods: we reviewed the medical records of 260 patients who fulfilled the inclusion criteria for active surveillance. We performed a head-to-head comparison between the histological findings of specimens after radical prostatectomy (RP) and prostate biopsies. The PSIM score was calculated on the basis of positivity according to cutoffs (neutrophil-to-lymphocyte ratio (NLR) 2.0, platelets-to-lymphocyte ratio (PLR) 118 and monocyte-to-lymphocyte-ratio (MLR) 5.0), with 1 point assigned for each value exceeding the specified threshold and then summed, yielding a final score ranging from 0 to 3. Results: median NLR was 2.07, median PLR was 114.83, median MLR was 3.69. Conclusion: we found a significantly increase in the rate of pathological International Society of Urological Pathology (ISUP) ≥ 2 with the increase of PSIM. At the multivariate logistic regression analysis adjusted for age, prostate specific antigen (PSA), PSA density, prostate volume and PSIM, the latter was found the sole independent prognostic variable influencing probability of adverse pathology.