{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:02:04Z","timestamp":1790341324114,"version":"4.1.0"},"reference-count":15,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Introduction: The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential prognostic biomarker in several solid tumors, including metastatic castration-resistant prostate cancer (mCRPC). However, its clinical utility remains controversial, particularly across different treatment modalities. Aim: To evaluate the prognostic value of baseline NLR in patients with mCRPC treated with abiraterone, enzalutamide, or docetaxel, and to assess its association with survival outcomes and PSA response.\nMethods: We conducted a retrospective, single-center study including patients with mCRPC treated between December 2019 and January 2022. Patients were stratified according to a prespecified NLR cut-off of 4. The primary endpoint was overall survival (OS), and the secondary endpoint was PSA progressionfree survival (PSA-PFS). PSA response at 6 months was also evaluated. Survival outcomes were estimated using the Kaplan-Meier method, and the association between NLR and OS was assessed using univariable Cox regression.\nResults: A total of 186 patients were included. Median age was 77.0 years, and median baseline PSA was 31.1 ng\/mL. Patients with NLR \u2265 4 (26.3%) had significantly worse OS compared to those with NLR &lt; 4, with median OS of 16 versus 30 months. NLR \u2265 4 was associated with an increased risk of death (HR 2.05, 95% CI 1.24-3.39, p = 0.005). When analyzed as a continuous variable, higher NLR was also associated with shorter OS (HR 1.12, 95% CI 1.05-1.20, p &lt; 0.001). Patients with higher NLR showed shorter PSA-PFS (8.0 vs 10.5 months). However, no significant differences were observed in PSA response at 6 months, including PSA50 and PSA90 rates.\nConclusions: Elevated NLR is associated with worse overall survival and earlier disease progression in patients with mCRPC treated with contemporary systemic therapies. While NLR does not appear to predict early biochemical response, it may reflect the durability of treatment benefit. These findings support NLR as a simple and clinically useful prognostic biomarker in mCRPC.<\/jats:p>","DOI":"10.4081\/aiua.2026.15630","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:01:10Z","timestamp":1786089670000},"source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of neutrophil-to-lymphocyte ratio in mCRPC patients treated with abiraterone, enzalutamide and docetaxel: a retrospective single-center study"],"prefix":"10.4081","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2079-8518","authenticated-orcid":false,"given":"Ana Marta","family":"Ferreira","sequence":"first","affiliation":[{"name":"Urology and Renal Transplantation Department, Centro Hospitalar e Universit\u00e1rio de Coimbra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Rego","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation Department, Centro Hospitalar e Universit\u00e1rio de Coimbra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasco","family":"Quaresma","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation Department, Centro Hospitalar e Universit\u00e1rio de Coimbra; Faculty of Medicine, University of Coimbra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Jarimba","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation Department, Centro Hospitalar e Universit\u00e1rio de Coimbra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Tavares da Silva","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation Department, Centro Hospitalar e Universit\u00e1rio de Coimbra; Faculty of Medicine, University of Coimbra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Nunes","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation Department, Centro Hospitalar e Universit\u00e1rio de Coimbra; Faculty of Medicine, University of Coimbra"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaldo","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Urology and Renal Transplantation Department, Centro Hospitalar e Universit\u00e1rio de Coimbra; Faculty of Medicine, University of Coimbra"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"245604","doi-asserted-by":"crossref","unstructured":"1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024; 74:17-48.","DOI":"10.3322\/caac.21820"},{"key":"245605","doi-asserted-by":"crossref","unstructured":"2. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71:209-49.","DOI":"10.3322\/caac.21660"},{"key":"245606","doi-asserted-by":"crossref","unstructured":"3. de Bono JS, Logothetis CJ, Molina A, et al. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med. 2011; 364:1995-2005.","DOI":"10.1056\/NEJMoa1014618"},{"key":"245607","doi-asserted-by":"crossref","unstructured":"4. Ryan CJ, Smith MR, de Bono JS, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013; 368:138-48.","DOI":"10.1056\/NEJMx130004"},{"key":"245608","doi-asserted-by":"crossref","unstructured":"5. Scher HI, Fizazi K, Saad F, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012; 367:1187-97.","DOI":"10.1056\/NEJMoa1207506"},{"key":"245609","doi-asserted-by":"crossref","unstructured":"6. Tannock IF, de Wit R, Berry WR, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med. 2004; 351:1502-12.","DOI":"10.1056\/NEJMoa040720"},{"key":"245610","doi-asserted-by":"crossref","unstructured":"7. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011; 144:646-74.","DOI":"10.1016\/j.cell.2011.02.013"},{"key":"245611","doi-asserted-by":"crossref","unstructured":"8. Guthrie GJ, Charles KA, Roxburgh CS, et al. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013; 88:218-30.","DOI":"10.1016\/j.critrevonc.2013.03.010"},{"key":"245612","doi-asserted-by":"crossref","unstructured":"9. Templeton AJ, McNamara MG, \u0160eruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106:dju124.","DOI":"10.1093\/jnci\/dju124"},{"key":"245613","doi-asserted-by":"crossref","unstructured":"10. Proctor MJ, Morrison DS, Talwar D, et al. A comparison of inflammation- based prognostic scores in patients with cancer: a Glasgow Inflammation Outcome Study. Br J Cancer. 2011;104:726-34.","DOI":"10.1038\/sj.bjc.6606087"},{"key":"245614","doi-asserted-by":"crossref","unstructured":"11. Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-related inflammation and treatment effectiveness. Lancet Oncol. 2014; 15:e493-503.","DOI":"10.1016\/S1470-2045(14)70263-3"},{"key":"245615","unstructured":"12. van Soest RJ, Templeton AJ, Vera-Badillo FE, et al. Neutrophilto- lymphocyte ratio as a prognostic biomarker for men with metastatic castration-resistant prostate cancer receiving first-line chemotherapy: data from two randomized phase III trials. Eur Urol. 2015;68:48-55."},{"key":"245616","doi-asserted-by":"crossref","unstructured":"13. Lorente D, Mateo J, Templeton AJ, et al. Baseline neutrophillymphocyte ratio (NLR) is associated with survival and response to treatment with second-line chemotherapy for advanced prostate cancer. Ann Oncol. 2015; 26:1688-93.","DOI":"10.1093\/annonc\/mdu587"},{"key":"245617","unstructured":"14. Leibowitz-Amit R, Templeton AJ, Omlin A, et al. Clinical variables associated with PSA response to abiraterone acetate in patients with metastatic castration-resistant prostate cancer. Clin Genitourin Cancer. 2014; 12:e51-7."},{"key":"245618","unstructured":"15. Azab B, Bhatt VR, Phookan J, et al. Usefulness of the neutrophilto-lymphocyte ratio in predicting short- and long-term mortality in prostate cancer patients. BJU Int. 2012; 109:1606-12."}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15630\/14313","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15630\/14313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:44:01Z","timestamp":1790340241000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/15630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,25]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2026.15630","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,7]]}}}