Objective To explore the number of examined lymph nodes(ELN)and positive lymph node ratio(LNR)in the prediction of 5-year and 10-year overall survival(OS)and cancer-specific survival(CSS)of prostate cancer(PCa)patients,so as to provide reference for clinical practice.Methods Information of PCa patients screened in the Surveillance,Epidemiology and End Results(SEER)database during 2010-2020 were analyzed.A total of 1842 PCa patients were assigned to the training set(n=1290)and validation set(n=552)in a 7∶3 ratio with R 4.3.0 software.Significant factors in the multivariate Cox proportional risk regression model were adjusted,restricted cubic spline plots(RCS)were plotted,the optimal cut-off values of ELN and LNR were determined,and the 5-year and 10-year OS and CSS were analyzed with restricted mean survival time(RMST).Results Multivariate Cox analysis showed that there was a 2.9％reduction in the risk of death with an increase of 1-unit ELN and a 3.1％reduction in the risk of cancer-specific death.There was a 481.4％increase in the risk of death with a 1-unit increase in LNR and a 667.5％increase in the risk of cancer-specific death.The risk of overall death and cancer-specific death in ELN and PCa patients showing a non-linear relationship(P＜0.001),while in the LNR and PCa patients showing a linear relationship(P＞0.05).RMST results showed that the optimal ELN range for evaluating OS was 12-29,the optimal ELN range for assessing CSS was 12-25,LNR＞0.152 indicated poor prognosis.Conclusion We have clarified the range of ELN and LNR,which can provide reference for the clinical precision diagnosis and treatment of PCa.
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