Analysis of the efficacy of ELRP in treating prostate cancer and the predictive value of NLR,PSAD,and ALP for patient prognosis
YU Jiafa
LI Xiang
ZHANG Hua
Abstract：Objective To investigate the efficacy of extraperitoneal laparoscopic radical prostatectomy(ELRP)in treating prostate cancer(PCa)and analyze the predictive value of neutrophil-to-lymphocyte ratio(NLR),prostate-specific antigen density(PSAD),and alkaline phosphatase(ALP)for patient prognosis.Methods A total of 196 PCa patients admitted to the Department of Urology in Zhoushan Hospital from November 2019 to November 2023 were selected as the object of study.According to different approaches,they were divided into transperitoneal laparoscopic radical prostatectomy(TLRP)group(n=94)and ELRP group(n=102).The end-point of follow-up was patient death or until November 30,2024.According to patient prognosis,they were divided into good prognosis group(n=143)and poor prognosis group(n=53).The perioperative indicators and postoperative in-hospital complications were compared between TLRP group and ELRP group.Poor prognosis of PCa patients was included as positive and good prognosis as negative,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of various indexes for poor prognosis of PCa patients.Results Compared with TLRP group,the operation time and postoperative recovery time of ELRP group were shorter,and the intraoperative blood loss was lower(P＜0.05).During the postoperative hospital stay,the complication rates in ELRP group and TLRP group were 1.96％and 9.57％,respectively,and the incidence in ELRP group was lower(P＜0.05).Among 196 PCa patients,53 had a poor prognosis,with an incidence of 27.04％.Multivariate logistic regression analysis showed that positive surgical margin(OR=1.790,95％CI=1.138-2.814),increased Gleason score(OR=1.870,95％CI=1.126-3.107),increased whole blood NLR(OR=1.833,95％CI=1.040-3.230),increased PSAD(OR=2.059,95％CI=1.299-3.263),and increased serum ALP level(OR=2.418,95％CI=1.419-4.121)were risk factors for poor prognosis in PCa patients(P＜0.05).The ROC curve was drawn to analyze the predictive value of NLR,PSAD,and ALP alone and in combination for poor prognosis of PCa patients.The areas under the curve were 0.830,0.674,0.818,and 0.931,and the combined detection was the highest(Z=2.626,5.541,and 2.585,P＜0.05),with sensitivity of 90.57％and specificity of 87.41％.Conclusion Compared with TLRP,ELRP can improve perioperative indicators and reduce the risk of complications in PCa.Positive surgical margin,increased Gleason score,increased whole blood NLR,increased PSAD,and increased serum ALP level are risk factors for poor prognosis in PCa patients.The combined detection of NLR,PSAD,and ALP has high predictive value for patient prognosis.
Keywords：prostate cancerextraperitoneal laparoscopic radical prostatectomyneutrophil-to-lymphocyte ratioprostate-specific antigen densityalkaline phosphatasepredictive value
Publication Date：2025-05-31
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 661-667 )