Yamada Y, Sakamoto S, Rii J, et al. - Investigators sought to confirm the prognostic significance of this peripheral inflammatory index in metastatic castration-resistant prostate cancer (mCRPC). This study retrospectively obtained clinical data of 196 mCRPC individuals from multiple institutions. They examined clinical factors and inflammatory markers at the development of CRPC, including white blood cell count, absolute neutrophil count, dNLR, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, C-reactive protein (CRP), and LDH levels. Individuals have divided into three groups based on the inflammatory index: Good (low dNLR and LDH), Intermediate (high dNLR or LDH), and Poor (high dNLR and LDH). Utilizing Cox proportional hazard models and Kaplan-Meier methods, overall survival (OS) and cancer-specific survival after CRPC were examined. The new inflammatory index combining dNLR and LDH was found to be a beneficial prognostic parameter in individuals with mCRPC. This study implied that, compared with NLR, dNLR emerged as a more valuable prognostic marker.