Prognostic significance of the neutrophil-to-lymphocyte ratio with distal cholangiocarcinoma patients

Abstract

Background: The present study aimed to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in distal cholangiocarcinoma (DCC) following radical surgery. Methods: The clinicopathological data of 59 patients with DCC were retrospectively reviewed. Patients were treated by radical surgery and diagnosed by postoperative pathology at the Second Affiliated Hospital of Kunming Medical University (Yunnan, China), between July 2015 and December 2017. The optimal cut-off value for the NLR was determined by generating receiver operating characteristic (ROC) curves. Kaplan–Meier survival analysis and Cox proportional hazards models were used to determine the risk factors and independent risk factors influencing the prognosis of patients with DCC. Results: According to the ROC curve, the optimal cut-off value for the NLR was 2.933. The results of Kaplan–Meier survival analysis and the Cox proportional hazards model showed that carbohydrate antigen 125, NLR, perineural, vascular and fat invasion, regional lymph node metastasis, and the American Joint Committee on Cancer stage were risk factors for DCC; the only independent risk factor to affect the prognosis of DCC patients was the NLR. Conclusions: The preoperative NLR plays an important guiding role in evaluating the prognosis of patients with DCC, and an increase in the NLR is associated with poor patient prognosis.

Prognostic Significance of Growth Pattern in Predicting Outcome of Opisthorchis viverrini-Associated Distal Cholangiocarcinoma in Thailand

“…Other studies propose additional factors, such as a prognostic factor, to improve prognosis in dCCA. Ji et al found that neutrophil-to-lymphocyte ratio (NLR) was associated with poor prognosis ( 33 ). Furthermore, the cancer biomarker, serum carbohydrate antigen 19–9, used as a prognostic factor for poor survival of dCCA patients correlated well with regional lymph node metastases ( 34 ).…”

“…As far as inclusion of DOI and number of lymph node metastasis is concerned, the verdict is still out ( 29 – 32 ). There has, however, been increasing studies proposing revisions of the updated 8th edition and alternative staging systems for classification ( 33 – 37 ).…”

The Value of Platelet-to-Lymphocyte Ratio as a Prognostic Marker in Cholangiocarcinoma: A Systematic Review and Meta-Analysis

“…The remaining 111 studies were further vetted for eligibility after the titles and abstracts were reviewed. Ultimately, 20 studies were included in the analysis [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ].…”

“…Eight studies identified the PLR as an independent predictor for impaired OS in patients with CCA [ 22 , 28 , 29 , 33 , 34 , 36 , 38 , 41 ], while the PLR was not prognostic for OS in twelve studies [ 23 , 24 , 25 , 26 , 27 , 30 , 31 , 32 , 35 , 37 , 39 , 40 ]. The combined analysis of all twenty publications showed that the PLR values higher than the defined cut-off values predicted a worse OS (HR = 1.14, 95% CI = 1.06–1.24, p < 0.01) with high heterogeneity (I 2 = 55%, p < 0.01, Figure 2 ).…”

“…These different cut-offs impede the routine application of the parameter in clinical management and warrant further research. As some studies did not report HRs and CIs in detail, these variables had to be extrapolated from the survival curves in four studies [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 37 , 39 ]. Further, the available data were unfortunately not sufficient to investigate the association between the PLR and tumor clinicopathological characteristics.…”