# Significance of Inflammation Markers to Predict Curative Treatment for Prostate Cancer Patients on Active Surveillance

## TL;DR

This study explores how inflammation markers can help predict which prostate cancer patients on active surveillance might need early curative treatment.

## Contribution

The study identifies potential inflammatory biomarkers for predicting the need for early treatment in prostate cancer patients on active surveillance.

## Key findings

- PSAD, NLR, PLR, and SII showed significant differences between groups requiring curative treatment and those not.
- ROC analysis determined cut-off values for PSAD, NLR, PLR, and SII to predict the need for early treatment.
- Inflammatory markers could guide clinicians in making early treatment decisions for prostate cancer patients.

## Abstract

Active surveillance (AS) strategy aims to avoid unnecessary or excessive early treatment in patients at a low risk for prostate cancer (PCa). However, a biomarker that can predict the need for early curative treatment in patients under AS has not been identified to date. In this study, we aimed to investigate the potential of inflammatory biomarkers in predicting the requirement of curative treatment in the early period in patients under AS.

This study included a total of 83 patients with the diagnosis of PCa and under AS. Patient age, prostate‐specific antigen (PSA) level, prostate volume (PV), PSA density (PSAD), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune‐inflammation index (SII) and follow‐up period were compared between the groups.

There was a significant difference between the two groups in terms of PSAD, NLR, PLR and SII (p = 0.037, p = 0.046, p = 0.008, p = 0.004 and p = 0.005, respectively). The cut‐off value determined by performing ROC analysis to evaluate the levels that predict the need for curative treatment before AS was 0.125 for PSAD (sensitivity: 61.8%, specificity: 61.2%), 2.01 for NLR (sensitivity: 67.6%, specificity: 55.1%), 115.49 for PLR (sensitivity: 73.5%, specificity: 59.2%) and 465.40 for SII (sensitivity: 70.6%, specificity: 59.2%).

The analysis of PSAD, NLR, PLR and SII before making the decision to conduct AS can guide clinicians regarding curative treatment in the early period.

There was no difference between the groups in terms of analyses of histopathological parameters performed in testis tissue. While testicular volume, sperm motility and the ratio of sperm cells with normal morphology were relatively smaller before the level of the internal inguinal ring in the testicular descent, we could not find significant differences in the histopathological parameters between groups.