The findings of this study demonstrated notable correlations between the SII/Ki-67 index and PCa prognosis following LRP, and uncovered that preoperative SII + Ki-67 index exhibited a superior predictive capability for post-LRP poor prognosis compared to either the SII or Ki-67 index alone, which provided valuable insights into the prognostic implications. This evidence concerns the gene MKI67 and posterior cortical atrophy.