Abstract

Inflammation-based prognostic indicators have been developed to predict the prognosis in patients with pancreatic cancer. However, prognostic indices have not been established in patients with unresectable pancreatic cancer, including those without indication for chemotherapy at diagnosis. This study aimed to identify the predictors in all patients with unresectable pancreatic cancer. We retrospectively analyzed data of 119 patients with unresectable pancreatic cancer from June 2006 to September 2018. The following laboratory parameters were evaluated: the Glasgow Prognostic Score (GPS), modified GPS, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein albumin (CRP/Alb) ratio, and prognostic nutritional index (PNI). We performed time-dependent receiver operating characteristic analysis, overall survival (OS) analysis, and univariate and multivariate analyses to determine the prognostic factors in patients with unresectable pancreatic cancer. The cut-off value for NLR was determined to be 3.74. The 6-month OS rates in low and high NLR groups were 75.5% and 18.8% (P < 0.001). In the univariate analysis, advanced age (P = 0.003), metastatic pancreatic cancer (P = 0.037), no treatment (P < 0.001), worse Eastern Cooperative Oncology Group Performance Status (ECOG-PS) (P < 0.001), high GPS (P < 0.001), high modified GPS (P < 0.001), high NLR (P < 0.001), high PLR (P = 0.002), high CRP/Alb ratio (P < 0.001), and low PNI (P < 0.001) were identified as the prognostic factors. The multivariate analysis revealed that metastatic pancreatic cancer (P = 0.046), no treatment (P < 0.001), worse ECOG-PS (P = 0.002), and high NLR (P < 0.001) were independently associated with OS. We revealed that the high NLR could be an independent indicator of poor prognosis in patients with unresectable pancreatic cancer.

Details

Title
Neutrophil to lymphocyte ratio predicts prognosis in unresectable pancreatic cancer
Author
Iwai Naoto 1 ; Okuda Takashi 2 ; Sakagami Junichi 3 ; Harada Taishi 4 ; Ohara Tomoya 2 ; Taniguchi Masashi 2 ; Sakai Hiroaki 2 ; Oka Kohei 2 ; Hara Tasuku 2 ; Tsuji Toshifumi 2 ; Komaki Toshiyuki 2 ; Kagawa Keizo 3 ; Yasuda Hiroaki 5 ; Naito Yuji 5 ; Itoh Yoshito 5 

 Fukuchiyama City Hospital, Department of Gastroenterology and Hepatology, Fukuchiyama-city, Japan; Kyoto Prefectural University of Medicine, Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto, Japan (GRID:grid.272458.e) (ISNI:0000 0001 0667 4960) 
 Fukuchiyama City Hospital, Department of Gastroenterology and Hepatology, Fukuchiyama-city, Japan (GRID:grid.272458.e) 
 Fukuchiyama City Hospital, Department of Gastroenterology and Hepatology, Fukuchiyama-city, Japan (GRID:grid.272458.e); Kyoto Prefectural University of Medicine, Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto, Japan (GRID:grid.272458.e) (ISNI:0000 0001 0667 4960) 
 Fukuchiyama City Hospital, Department of Medical Oncology, Fukuchiyama-city, Japan (GRID:grid.272458.e) 
 Kyoto Prefectural University of Medicine, Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto, Japan (GRID:grid.272458.e) (ISNI:0000 0001 0667 4960) 
Publication year
2020
Publication date
2020
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2471529254
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.