The importance of de-ritis ratio in prediction of pathological results in prostate cancer

Objective: The usefulness of the preoperative De Ritis ratio in predicting post-operative ISUP-GG (International Society of Urological Pathology Grade Group) upgrading and pathological outcomes was examined in this study. Materials and Methods: In our study, 152 patients who underwent radical prostatectomy for localized prostate cancer between 2012 and 2022 were retrospectively analyzed. Blood samples including AST and ALT were collected a month before surgery. Age, preoperative tumor characteristics, such as pre-biopsy PSA, prostate volume, PSA density, biopsy ISUP-GG, maximum biopsy tumour volume, and prostatectomy pathological features, such as ISUP-GG, pathological tumour stage, lymph node involvement, seminal vesicle invasion, and surgical margin status, were assessed. Results: The mean De Ritis ratio was found to be lower in the group with ISUP upgrading than in the group without upgrade following radical prostatectomy (1,14±0,28 versus 1,10±0,27, p=0.38). The optimal cutoff value for the De Ritis ratio was 1.22 as a result of the ROC curve study to predict the upgrade. The group with a low De Ritis ratio had a greater rate of upgrading, which was statistically significant (51% versus 34%, p=0.05). Pathological T3, seminal vesicle invasion, and lymph node invasion rates were observed to be higher in patients with low De Ritis ratio following radical prostatectomy, although this finding was not statistically significant (p values of 0.68, 0.50, and 0.39, respectively). Conclusions: According to our research, a low De Ritis ratio may be linked to ISUP upgrading and unfavorable pathological traits (T3, lymph node involvement, and seminal vesicle invasion) following radical prostatectomy.