Host systemic inflammatory response influences outcome in pancreatic cancer

Imrie, C. W.

doi:10.1016/j.pan.2015.04.004

Cited by 21 publications

(28 citation statements)

References 26 publications

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“…We then explored the predictive role of NLR in RFS and showed that high NLR was associated with decreased RFS. Association between high NLR and decreased survival has been reported for various tumors, including pancreatic adenocarcinoma . However, relationships between inflammatory markers and survival of SPTP have never been investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Association between high NLR and decreased survival has been reported for various tumors, including pancreatic adenocarcinoma. 17 However, relationships between inflammatory markers and survival of SPTP have never been investigated. To our knowledge, this is the first study demonstrating the prognostic impact of NLR in SPTP.…”

Section: Predictive Factors Of Malignant Sptpmentioning

confidence: 99%

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Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Yang

Bao

Zhou

et al. 2019

Journal of Surgical Oncology

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Background Systemic inflammatory markers such as neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have been shown to be prognostic for many types of pancreatic malignancy. The aim of this study was to evaluate the prognostic role of these markers in patients with solid pseudopapillary tumor of the pancreas (SPTP). Methods Patients who underwent surgical resection for histologically confirmed SPTP were retrospectively reviewed in our institution. Preoperative NLR and PLR were calculated. Clinicopathologic data were correlated with the presence of malignant potential and recurrence‐free survival (RFS). Results A total of 113 patients with SPTP were included in this study. Of them, 23 were men and 90 were women, with a median age of 35 years (interquartile range, 25‐44). The optimal cut‐off values for malignant SPTP were 3.22 for NLR, and 75.5 for PLR, respectively. Univariate analysis showed that high NLR (>3.22) and white blood cell count more than 9.96 × 109/L were predictive of a malignant SPTP. Meanwhile, high NLR (P = 0.001) and age more than 35 years (P = 0.026) were associated with worse RFS. On multivariable analyses, high NLR was the only independent predictor of malignant SPTP (odd ratio 6.871; 95% confidence interval [CI], 1.482‐31.864; P = 0.014) and RFS (hazard ratio 12.633; 95% CI, 1.758‐90.790; P = 0.012). Conclusions This study highlights the supportive role of preoperative NLR in predicting malignancy and RFS of SPTP patients. Further studies including a larger cohort of patients are needed to corroborate our findings.

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Section: Discussionmentioning

confidence: 99%

Section: Predictive Factors Of Malignant Sptpmentioning

confidence: 99%

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Yang

Bao

Zhou

et al. 2019

Journal of Surgical Oncology

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“…36 Accordingly, specific scores have been established on the basis of inflammatory markers that have been validated as prognosticators of therapy response and outcome in patients with solid malignancies. 6,7,9,17,18,20,[37][38][39][40][41] However, some of these prognostic scores require extended analysis of differential blood cell count, which is not routinely measured in patients with primary PDAC undergoing resection. [6][7][8]10,18,40,41 The PI involves CRP and WBC as prognostic biomarkers.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] However, the body's inflammatory response to the presence of a malignancy was frequently neglected, despite that it showed a significant impact on outcome in PDAC. [6][7][8][9][10] Among a wide range of inflammatory mediators, cytokines stimulate tumour development at different stages from tumourigenesis to dissemination. In addition, they affect treatment response and are associated with rapid deterioration and a dismal prognosis.…”

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confidence: 99%

The Prognostic Index Independently Predicts Survival in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Resection

et al. 2020

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Background. Cancer-related inflammation is associated with tumour proliferation, maintenance and dissemination. It therefore impacts pancreatic cancer survival. The goal of this study was to examine the Prognostic Index (PI) as a prognostic biomarker for survival in patients with pancreatic ductal adenocarcinoma (PDAC). In addition, we explored factors known to interact with the immune and inflammation cascade that might interfere with the PI's strength for prognostication. Methods. Patients with PDAC undergoing resection were analysed retrospectively. The PI was calculated from preoperatively derived C-reactive protein levels and white blood count. Data were subject to correlation and survival analysis.Results. Of 357 patients, 235 (65.8%) patients had a PI 0, 108 (30.3%) PI 1, and 14 (3.9%) PI 2. Median (quartiles) survival with a high PI (group 1 ? 2) was 13.2 months (7.7-27.0), compared with 18.7 months (10.2-35.4) with a low PI (group 0; p = 0.012). The PI proved to be an independent prognostic factor for cancer-specific survival (p = 0.003) adjusted for conventional prognostic factors. Prognostic strength was influenced by the presence of a bile stent (p = 0.032). Conclusions. The PI is a strong and solid independent prognostic tool for survival in patients with PDAC undergoing resection. Preoperative survey of inflammatory activity as provided by the use of a biomarker like the PI may help to identify those patients at risk of a poor prognosis.

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“…The correlation between an elevated NLR and a poor prognosis has been confirmed in many tumors, such as lung [14], colorectal [13], stomach [15] and liver [16]. However, whether the NLR can be applied as an independent prognostic predictors in PC has remained controversial up to now [17]. Clark et al and Sanjay et al found no prognostic value of an elevated NLR in patients with PC who had primary tumor resection [18,19], while in contrast, more studies have shown that an increased NLR may be utilized as a predictor of survival in patients with PC [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

The combination of serum NLR and D-dimer levels at diagnosis predicts overall survival in metastatic pancreatic cancer

Mei¹,

Gong²,

Yao³

et al. 2020

Preprint

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Background Many studies have confirmed that the systemic inflammatory response and hypercoagulable state of the patient are related to the occurrence and development of various tumors, including pancreatic cancer. The aim of this research was to combine blood inflammatory factors and D-dimer into a new prognostic scoring system.Methods We conducted a retrospective cohort study of 73 patients with metastatic pancreatic cancer between January 2015 and December 2018 at our institution. To identify the prognostic predictors, circulating inflammatory cells and D-dimer were analyzed.Results Univariate analysis showed that the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), CA19-9, Eastern Cooperative Oncology Group performance status (ECOG PS) score and D-dimer levels were significantly associated with overall survival in patients with metastatic pancreatic cancer. Multivariate analysis suggested that only the NLR (p<0.026) and D-dimer level (p<0.012) were independent prognostic predictors. Then, we combined the NLR and D-dimer level to divide the cohort into three “NLRD” groups: “NLRD0”=NLR≤3.38 and D-dimer≤1.47, “NLRD1”=either NLR>3.38 or D-dimer>1.47, “NLRD2”=NLR>3.38 and D-dimer>1.47. Finally, we found that the NLRD2 group had the worst survival, with a median overall survival (OS) of 2 months (95%CI=1.450-2.550), while the NLRD0 group had the best outcome, with a median OS of 7 months (95%CI=5.897-8.121).Conclusions The scoring system combining the blood NLR with D-dimer levels provides important prognostic information for risk stratification in patients with metastatic pancreatic cancer and may help us identify patients who have a poor prognosis so that clinicians can develop personalized treatment strategies for these patients.

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Host systemic inflammatory response influences outcome in pancreatic cancer

Cited by 21 publications

References 26 publications

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

The Prognostic Index Independently Predicts Survival in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Resection

The combination of serum NLR and D-dimer levels at diagnosis predicts overall survival in metastatic pancreatic cancer

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