Preoperative lymphocyte count as a prognostic factor in resected pancreatic ductal adenocarcinoma

Clark, E. J.; Connor, Saxon; Mb, Taylor; Madhavan, K.K.; Garden, O. James; Parks, Rowan W.

doi:10.1080/13651820701774891

Cited by 122 publications

(103 citation statements)

References 37 publications

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“…The immune response has been found to differ depending on the type of cancer. With pancratic cancer, a marked increase in lymphocytes occurs preoperatively and postoperative [25]. The NLR was not associated with the prognosis of pancratic cancer.…”

Section: Discussionmentioning

confidence: 96%

The pretreatment neutrophil-to-lymphocyte ratio predicts therapeutic response to radiation therapy and concurrent chemoradiation therapy in uterine cervical cancer

et al. 2015

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Objective: The aim of this study was to investigate the prognostic role of the pretreatment neutrophil-to-lymphocyte ratio (NLR) as a predictive marker prior to treatment of cervical cancer with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT).Methods: Fifty-six patients with squamous cell carcinoma (SCC) of the uterine cervix who underwent RT or CCRT from 2005 to 2013 at this Hospital were retrospectively identified using electronic databases.Patients were divided into a high NLR group (≥ 2.5) and a low NLR group (< 2.5). The efficacy of RT and CCRT in the two groups was compared.Result: Of the 56 patients, 35 were in the high NLR group and 21 were in the low NLR group. In comparison to a high NLR, a low NLR was significantly associated with a complete response (P < 0.001).When cancer was divided into stages I/II and III/IV, patients with a low NLR had a significantly better therapeutic outcome than those with a high NLR (P < 0.05). Multivariate analysis showed that only the NLR was a significant prognostic factor for progression-free survival (PFS). Patients with a high NLR had a significantly shorter PFS and overall survival than those with a low NLR.Conclusion: Results showed that a low NLR before treatment can predict a good response to RT or CCRT by all stages of uterine cervical cancer. The NLR may be a promising parameter on which to base the choice of a therapeutic strategy to treat SCC of the uterine cervix.

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Section: Discussionmentioning

confidence: 96%

The pretreatment neutrophil-to-lymphocyte ratio predicts therapeutic response to radiation therapy and concurrent chemoradiation therapy in uterine cervical cancer

et al. 2015

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“…The reduced lymphocyte count is connected with an increased number of septic complications during the postoperative period (7,8,27). Considering the 65 patients subject to pancreatoduodenal area resections the average lymphocyte count was 2.13 K/µL.…”

Section: Discussionmentioning

confidence: 99%

“…Algorithm data considering the extent of the operation, predicted blood loss, presence of cancer and tumor stage, as well as type of operation are known surgical perioperative risk factors. Each of the above-mentioned factors were considered independently showing the prognostic value in patients subject to pancreatoduodenal area resections (1,3,4,5,7,9,10,18,20,25,27). A comparable range of surgery in all patients is burdened with significant risk of complications, and resections of the pancreas and duodenum are considered as the most extensive and difficult operations of the alimentary tract (1, 4, 5, 30).…”

Section: Discussionmentioning

confidence: 99%

The Possum Scoring System and Complete Blood Count in the Prediction of Complications After Pancreato-Duodenal Area Resections

Dębińska¹,

Smolińska²,

Osiniak³

et al. 2011

Polish Journal of Surgery

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The introduction of markers which help in the identification of patients prone to suffer from postoperative complications enables to recognize them more easily and thus, treat them more effectively. the aim of the study was to evaluate complete blood count indicators, as well as preoperative results obtained on the basis of the PoSSUM and P-PoSSUM scoring systems, considering the prediction of complications after surgical resections in the pancreato-duodenal area. material and methods. A prospective 30-day non-interventional clinical study was conducted on a group of 65 patients who underwent scheduled surgery, due to pancreatic head cancer or chronic pancreatitis. Total pancreatoduodenectomy was performed in 24.1% of patients, while the remaining were subject to hemi-pancreatoduodenectomy. The authors evaluated the preoperative complete blood count parameters, as well as the risk of complications and mortality using the audit PoSSUM and P-PoSSUM scoring systems. Results. Postoperative complications were observed in 32.4% of patients. The white blood cell count and platelet count in the preoperative period were statistically lower in the group of patients with postoperative complications, in comparison to patients without diagnosed complications. Higher severity scores obtained by means of the P-PoSSUM scoring system, as well as higher mortality during the perioperative period can be ascribed to patients who suffered postoperative complications. However, no correlation was found between the occurrence of complications and gender, age, type of resection, preoperative hemoglobin level, absolute lymphocyte count, or numerical value representing the patient's general condition (PoSSUM) and predicted postoperative morbidity. conclusions. The absolute white blood cell count and total platelet count during the preoperative period may be considered as an indicator of the higher risk of complications during pancreato-duodenal area resections. The usefulness of the PoSSUM and P-PoSSUM scoring systems is limited. However, the surgical severity index and calculated mortality coefficient risk can facilitate the identification of patients threatened with postoperative complications. Key words: complete blood count, surgical severity index, PoSSUM and P-PoSSUM scoring systems, pancreato-duodenal area, pancreatoduodenectomy Anatomical conditions and complex pathophysiological processes are responsible for the difficulties connected with the surgical management of patients with pancreatic disorders. Pancreatic resections are considered as difficult operations connected with increased risk of postoperative complications (1).Progress in pancreatic surgery, lead towards significant mortality reduction after resection procedures, especially in specialistic centers. Postoperative complications continue to pose a significant problem concerning 25-40% of patients subject to pancreatoduodenectomies, influencing the final treatment result,

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“…To date, several studies also have shown that decreased preoperative LC was related to poor prognosis in various types of cancers including pancreatic cancer [10], esophageal cancer [11], renal cancer [12], and sarcoma and lymphoma [15]. Lymphocytes include CD4 + and CD8 + T cells, natural killer (NK) cells, NKT cells, gamma-delta T cells, and B cells, which are reported to be closely associated with tumor immunity.…”

Section: Discussionmentioning

confidence: 99%

“…Functional impairment of lymphocytes and decreased lymphocyte counts (LCs) have been reported in various types of cancers [8, 9]. Preoperative lymphopenia is reportedly associated with poor prognosis in several cancers [10-12], and this indicates that preoperative lymphopenia may reflect impaired host anticancer defense mechanisms. However, we previously reported that a rapid and significant decrease in total lymphocyte numbers was observed after surgery for GC [13].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Pre- and Postoperative Lymphocyte Counts in Patients with Gastric Cancer

et al. 2018

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Background: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. Methods: We enrolled 352 patients who underwent surgery for gastric cancer (GC) between January 2005 and April 2013 to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in GC patients. Results: Pre- and postoperative (obtained 1 day after surgery) LCs were significantly correlated (r = 0.496, p < 0.0001). Pre- and postoperative LCs of elderly patients were significantly lower than those of non-elderly patients. Postoperative lymphocyte count was significantly lower in patients with a differentiated tumor than in those with an undifferentiated tumor. Based on the results of receiver operating characteristic analysis, patients were classified into subgroups as: preoperative LC ≥1,676 (pre-LC^High), preoperative LC <1,676 (pre-LC^Low); and as postoperative LC ≥855 (post-LC^High), and postoperative LC <855 (post-LC^Low). Five-year overall survival rates significantly differed between pre-LC^High (82.5%) and pre-LC^Low (71.6%) groups (p = 0.023); and also between the post-LC^High (81.5%) and post-LC^Low (69.5%) groups (p = 0.0072). The 5-year disease specific survival rates were 91.3 and 82.4% in patients with post-LC^High and those with post-LC^Low, respectively, and differences were statistically significant (p = 0.015). Multivariate analysis indicated that postoperative lymphocyte count was an independent prognostic indicator, along with age, gender, tumor size, lymph node metastasis, and venous invasion. Conclusions: Postoperative lymphocyte count is a useful predictive factor for prognosis in GC patients.

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Preoperative lymphocyte count as a prognostic factor in resected pancreatic ductal adenocarcinoma

Abstract: Preoperative lymphocyte count is a significant prognostic factor in patients with PDAC.

Cited by 122 publications

References 37 publications

The pretreatment neutrophil-to-lymphocyte ratio predicts therapeutic response to radiation therapy and concurrent chemoradiation therapy in uterine cervical cancer

The pretreatment neutrophil-to-lymphocyte ratio predicts therapeutic response to radiation therapy and concurrent chemoradiation therapy in uterine cervical cancer

The Possum Scoring System and Complete Blood Count in the Prediction of Complications After Pancreato-Duodenal Area Resections

Prognostic Significance of Pre- and Postoperative Lymphocyte Counts in Patients with Gastric Cancer

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