Pre-treatment neutrophil to lymphocyte ratio as a predictive marker for pathological response to preoperative chemoradiotherapy in pancreatic cancer

Hasegawa, Shinobu; Eguchi, Hidetoshi; Tomokuni, Akira; Tomimaru, Yoshito; Asaoka, Tadafumi; Wada, Hiroshi; Hama, Naoki; Kikuchi, Kôichi; Kobayashi, Shogo; Marubashi, Shigeru; Konnno, Masamitsu; Ishii, Hideshi; Mori, Masaki; Doki, Yuichiro; Nagano, Hiroaki

doi:10.3892/ol.2015.4057

Cited by 50 publications

(39 citation statements)

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“…The Arima et al32 study demonstrated a potential diagnostic role of NLR>5 for PDAC in patients with pancreatic neoplastic disease. Additionally a Japanese group investigated the link between pre-treatment NLR and the pathological response to preoperative chemotherapy in pancreatic cancer patients, thereby concluding that the pre-treatment NLR is an independent predictive marker of the pathological response to preoperative therapy 33. Similarly the Luo et al34 study reported that a baseline NLR and post-chemotherapy NLR change is appropriate to review to potentially serve as biomarkers for overall survival in patients who undergo chemotherapy having been diagnosed with pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

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

Giakoustidis

Neofytou

Neves

et al. 2018

Ann Hepatobiliary Pancreat Surg

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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.

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Section: Discussionmentioning

confidence: 99%

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

Giakoustidis

Neofytou

Neves

et al. 2018

Ann Hepatobiliary Pancreat Surg

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“…The neutrophil‐to‐lymphocyte ratio (NLR) was introduced more recently to represent probably, at least in most cases, the same phenomenon, and this appears to be an even better predictor for poor disease and treatment outcome (reviewed in ). Different types of cancer where a high NLR correlates with poor survival, and in some cases also a worse response to treatment, include melanoma , hepatocellular carcinoma , non–small cell lung cancer , colorectal cancer , nasopharyngeal carcinoma , breast cancer , intrahepatic cholangiocarcinoma , prostate cancer , pancreatic cancer , and gastric cancer . The NLR appears in most cases a reflection of the systemic inflammatory response that occurs as a consequence of the cancer in patients, and it makes sense that this response is most pronounced in advanced cancer .…”

Section: Neutrophils In Cancermentioning

confidence: 99%

Neutrophils in cancer

Treffers

Hiemstra

Kuijpers

et al. 2016

Immunological Reviews

164

145

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Summary Neutrophils play an important role in cancer. This does not only relate to the well‐established prognostic value of the presence of neutrophils, either in the blood or in tumor tissue, in the context of cancer progression or for the monitoring of therapy, but also to their active role in the progression of cancer. In the current review, we describe what is known in general about the role of neutrophils in cancer. What is emerging is a complex, rather heterogeneous picture with both pro‐ and anti‐tumorigenic roles, which apparently differs with cancer type and disease stage. Furthermore, we will discuss the well‐known role of neutrophils as myeloid‐derived suppressor cells (MDSC), and also on the role of neutrophils as important effector cells during antibody therapy in cancer. It is clear that neutrophils contribute substantially to cancer progression in multiple ways, and this includes both direct effects on the cancer cells and indirect effect on the tumor microenvironment. While in many cases neutrophils have been shown to promote tumor progression, for instance by acting as MDSC, there are also protective effects, particularly when antibody immunotherapy is performed. A better understanding of the role of neutrophils is likely to provide opportunities for immunomodulation and for improving the treatment of cancer patients.

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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%

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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Pre-treatment neutrophil to lymphocyte ratio as a predictive marker for pathological response to preoperative chemoradiotherapy in pancreatic cancer

Cited by 50 publications

References 45 publications

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

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

Neutrophils in cancer

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

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