4. Discussion
prostate cancer
PROSTATE CANCER, METASTASES, BONE METASTASES
The purpose of the present study is to report preliminary data about candidate biomarkers in oligorecurrent PCa representing the nutritional and inflammatory status. No valuable biomarkers related to the nutritional and inflammatory status able to help in oligometastatic Pca patients stratification were found in the present analysis. These results reflect the current scientific literature on the topic where there appears to be a paucity of biomarkers able to assess specific time points or different settings of PCa development [Nevertheless, we were able to report evidence that the addition of ADT appears to have an impact on cholesterol and albumin levels, two markers of deteriorating quality of life. In line with the present results, reporting a median increase of 8% for cholesterol levels, several studies showed a mean increase of 3.2–10.6% in total cholesterol with the duration of ADT ranging from 24 weeks to 12 months in the first 3 or 6 months of ADT [Additionally, evidence from our study showed that the site of metastases and inflammatory status appear to be associated, indeed, NLR and NLAR values were found to increase in patients with bone localizations, and, although not significant, an increasing trend in PLR was observed as well. As bone localizations are linked to a lower response rate than lymph node-only sites, this outcome is consistent with the well-known fact that a higher inflammatory status results in a worse prognosis. These results are in line with the study from Zhang et al. found a significant increase in NLR values and PLR in PCa patients with bone metastases [When patients were divided into quartiles according to the time from surgery to oligorecurrence, 38% of the patients in the fourth quartile, with a median time to oligorecurrence > of 6.7 years, experienced a higher increase in the CONUT score. The CONUT score is used to assess the patients’ preoperative nutritional status and in a recent publication by Zhang et al. [The present study is not exempt from limitations, first and foremost of which is the limited number of patients and the paucity of patients (To conclude, a reliable biological characterization of the oligometastatic state in prostate cancer still seems far from being achieved. The nutritional and inflammatory parameters examined in the current study do not seem to represent valuable candidates for possible use in clinical decision making in our cohort of patients. The presented data are going to be implemented with mutational landscape data from ctDNA of the enrolled patients for which next-generation sequencing (NGS) analyses are currently ongoing. These analyses will hopefully offer a valuable piece of evidence to stratify oligometastatic patients according to whether they benefit from more or less aggressive therapies.