American journal of translational research · 2026
Effects of neoadjuvant novel endocrine therapy combined with prostatic artery embolization on SII, PNI, and bRFS in patients with prostate cancer.
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Zhao Binyu, Li Bo, Jiang Jinquan, Ma Qiang, Zhang Huibo, You Jianjun, Li Kai
Аннотация
OBJECTIVE: To investigate the effects of neoadjuvant novel endocrine therapy combined with prostatic artery embolization (PAE) on systemic immune-inflammation index (SII), prognostic nutritional index (PNI), and biochemical recurrence-free survival (bRFS) in patients with high-risk or locally advanced prostate cancer, and to evaluate the feasibility of SII/PNI as early prognostic biomarkers.
METHODS: A retrospective analysis was conducted on 339 patients treated between Feb 2019 and Mar 2023, including 174 patients in the combination group (endocrine therapy + PAE) and 165 in the control group (endocrine therapy alone). PSA50/PSA90 response rates, surgical conversion rate, and changes in SII and PNI at 1 and 3 months after treatment were compared between the two groups. Kaplan-Meier analysis was used to evaluate bRFS, and time-dependent receiver operating characteristic (ROC) curves were applied to assess the predictive value of SII and PNI for 1- and 2-year bRFS.
RESULTS: The combination group demonstrated significantly higher PSA50/PSA90 response rates (P<0.05), higher surgical conversion rate (66.7% vs. 42.4%, P<0.001), greater reductions in SII (≥30%: 83.3% vs. 64.2%), and more pronounced PNI improvement (≥45: 82.9% vs. 69.7%, P<0.01) compared with the control group. The 1- and 2-year bRFS rates increased by 8.4% and 11.2%, respectively (P<0.05). SII and PNI measured at 3 months showed good predictive performance for bRFS, with AUC values ranging from 0.73 to 0.83. Survival analysis based on SII/PNI stratification revealed significant differences between groups (P<0.05).
CONCLUSION: The combined regimen accelerates PSA reduction, improves surgical feasibility, and alleviates systemic inflammation and nutritional status. SII/PNI detection at 3 months may facilitate early identification of recurrence risk and guide individualized treatment adjustment.
METHODS: A retrospective analysis was conducted on 339 patients treated between Feb 2019 and Mar 2023, including 174 patients in the combination group (endocrine therapy + PAE) and 165 in the control group (endocrine therapy alone). PSA50/PSA90 response rates, surgical conversion rate, and changes in SII and PNI at 1 and 3 months after treatment were compared between the two groups. Kaplan-Meier analysis was used to evaluate bRFS, and time-dependent receiver operating characteristic (ROC) curves were applied to assess the predictive value of SII and PNI for 1- and 2-year bRFS.
RESULTS: The combination group demonstrated significantly higher PSA50/PSA90 response rates (P<0.05), higher surgical conversion rate (66.7% vs. 42.4%, P<0.001), greater reductions in SII (≥30%: 83.3% vs. 64.2%), and more pronounced PNI improvement (≥45: 82.9% vs. 69.7%, P<0.01) compared with the control group. The 1- and 2-year bRFS rates increased by 8.4% and 11.2%, respectively (P<0.05). SII and PNI measured at 3 months showed good predictive performance for bRFS, with AUC values ranging from 0.73 to 0.83. Survival analysis based on SII/PNI stratification revealed significant differences between groups (P<0.05).
CONCLUSION: The combined regimen accelerates PSA reduction, improves surgical feasibility, and alleviates systemic inflammation and nutritional status. SII/PNI detection at 3 months may facilitate early identification of recurrence risk and guide individualized treatment adjustment.