Prognostic Value of the Postoperative Advanced Lung Cancer Inflammation Index in Patients with Prostate Cancer...

This study investigated whether the postoperative advanced lung cancer inflammation index (ALI) has prognostic significance in patients with prostate cancer who underwent radical prostatectomy. It also explored the potential role of ALI as a biomarker for assessing postoperative recurrence risk.

This retrospective, single-center study included 425 patients with localized or selected locally advanced prostate cancer who underwent radical prostatectomy at the First Affiliated Hospital of Chengdu Medical College. Postoperative ALI was calculated using clinical and laboratory data obtained at the first follow-up visit, approximately three months after surgery. Patients were categorized into low- and high-ALI groups according to the optimal ALI cut-off value. Associations between postoperative ALI and overall survival and biochemical recurrence-free survival were evaluated using Kaplan-Meier analysis, Cox proportional hazards regression, and propensity score matching. The median follow-up duration was 56 months, 38 patients dead, and 156 patients had biochemical recurrences at the end of follow-up.

A low postoperative ALI was significantly associated with a lower body mass index (p = 0.001), higher Gleason scores (p = 0.0036), elevated preoperative prostate-specific antigen levels (p < 0.0001), more advanced pathological T stage (p < 0.0001), and a greater frequency of lymph-node metastasis (p = 0.002). Kaplan-Meier survival curves demonstrated that patients in the low-ALI group experienced worse survival outcomes, including reduced overall survival (HR = 3.32; 95% CI, 2.41-5.87; p = 0.012) and shorter biochemical recurrence-free survival (HR = 2.57; 95% CI, 1.58-3.65; p = 0.002), compared with those in the high-ALI group. In multivariable Cox regression models, ALI remained an independent predictor of both overall survival (p < 0.0001) and biochemical recurrence-free survival (p < 0.0001) after adjustment of confounding factors.

Among patients with prostate cancer undergoing radical prostatectomy, a low postoperative ALI was associated with shorter overall survival and biochemical recurrence-free survival compared with a high postoperative ALI. These findings suggest that postoperative ALI may provide prognostic information in patients undergoing radical prostatectomy; however, its clinical utility requires confirmation through prospective, multicenter studies and external validation.