Identifying the role of neutrophil-to-lymphocyte ratio and platelets-to-lymphocyte ratio as prognostic markers in patients undergoing resection of pancreatic ductal adenocarcinoma

Abstract

Backgrounds/AimsIt is important to point out that the identification of inflammation is an essential component of the pathogenesis and the progression of cancer. In this study, we analysed the neutrophil-to-lymphocyte ratio (NLR) and the platelets-to-lymphocyte ratio (PLR), with an overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC), who were treated with a resection following or not following a procedure of neoadjuvant chemotherapy/chemoradiation. We intended to identify the significance of the role of NLR and PLR, as prognostic markers in patients undergoing surgery for PDAC.MethodsThere were 127 patients enrolled in the study. The NLR and PLR were calculated on the basis of the pre-treatment blood cell count. An NLR>4 and a PLR >120 were considered to be elevated as measured. OS was analysed in relation to the NLR and PLR values, by using both the Kaplan-Meier and multivariate Cox-regression methods.ResultsBoth high the NLR and high PLR were associated with a decreased OS in the univariate analysis. In the multivariate analysis, the high NLR, but not the high PLR, was an independent predictor of a decreased OS. When we divided patients into three groups (group 1: normal both NLR and PLR, group 2: high NLR or high PLR, group 3: high both NLR and PLR), the three-years OS rates for these groups were 48%, 32%, 7% (p=0.001) respectively.ConclusionsIt is noted that the pre-treatment NLR is an independent adverse prognostic factor, and considered to be superior to the PLR, in patients who undergo a resection for PDAC following or not neoadjuvant chemotherapy/chemoradiation.

Independent effect of postoperative neutrophil-to-lymphocyte ratio on the survival of pancreatic ductal adenocarcinoma with open distal pancreatosplenectomy and its nomogram-based prediction

“…In addition, amounts of studies have showed the prognostic value of preNLR in localized or advanced pancreatic cancer, and an elevated preNLR was significantly correlated to shorter survival or PDAC occurrence 4,[10][11][12] . The cut-off value of preNLR as previously literatures reported was around 2.0-5.0 4,13,14 . However, few studies reported prognostic value of elevated NLR in ODPS patients.…”

A Simple Model Established by Blood Markers Predicting Overall Survival After Radical Resection of Pancreatic Ductal Adenocarcinoma

“…Macrophages (TAMs), which are derived from circulating monocytes, can promote tumor migration and proliferation (23). The study of Alexandros Giakoustidis also got the same conclusion (24), so NLR and LMR should be included in the regular assessment indexes of PDAC patients.…”

The Relationship Between Acute Kidney Injury and Inflammation-Based Parameters and Mortality in Oncologic Intensive Care Patients

“…Giakoustidis A. et al demonstrated that the role of NLR and PLR after pancreatic ductal adenocarcinoma resection is important in shaping treatment and predicting survival. In the same study, coexistence of high NLR and PLR was found to be associated with lower survival, but elevated NLR was a more important independent predictor than PLR (28). These studies have shown that PLR is not as valuable as NLR in predicting prognosis in malignancies.…”