The Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Are Prognostic Factors in Patients with Locally Advanced Pancreatic Cancer Treated with Chemoradiotherapy

Abstract

Background/AimsWe investigated whether inflammatory markers such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) independently and in combination would be significant prognostic factors for survival in patients with locally advanced pancreatic cancer.MethodsA total of 497 patients with locally advanced pancreatic cancer who received neoadjuvant or definitive chemoradiotherapy from 2005 to 2015 were evaluated. We divided the patients into groups according to the median values of NLR and PLR: NLR<1.89 (n=156), NLR≥1.89 (n=341), PLR <149 (n=248) and PLR≥149 (n=249).ResultsFor NLR <1.89 and ≥1.89 groups, respectively, the 1-year overall survival (OS) rates were 73.2% and 60.8% (p<0.001) and 1-year progression-free survival (PFS) rates were 43.9% and 31.3% (p<0.001). For PLR <149 and ≥149 groups, respectively, the 1-year OS rates were 68.1% and 61.3% (p=0.029) and 1-year PFS rates were 37.9% and 32.5% (p=0.027). Patients with both high NLR and high PLR showed the worst OS and PFS rates compared with those with both lower NLR and lower PLR.ConclusionsElevated pretreatment NLR and PLR independently and in combination significantly predicted poor OS and PFS.

Systemic Blood Immune Cell Populations as Biomarkers for the Outcome of Immune Checkpoint Inhibitor Therapies

“…Hence, high pretreatment NLR ratios (>2.2) and high LDH correlate with progression in nivolumab-treated patients with advanced NSCLC [20]. This is in agreement with other studies that utilize NLR as a biomarker in oncology [18,21,22].…”

Marriage predicts for survival in patients with stage III non–small-cell lung cancer

“…A similar conclusion can be drawn about immunologic status. NLR has previously been shown to be prognostic in a number of cancers, [13][14][15][16] including in our own cohort. 8 Although immune status remains an important predictor for OS in our locally advanced NSCLC population, when we take NLR into consideration in our analysis, marital status continues to be a strong indicator for survival ( Table 2).…”

Are the Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Prognostic Factors for Patients with Locally Advanced Pancreatic Cancer Treated with Chemoradiotherapy?

“…For example, prognostic nutritional index, 5 plasma fibrinogen levels, 5 presence of ascites, 6 serum albu-min levels, 7 and so forth, were not provided, and these factors might actually influence the prognosis in patients with locally advanced pancreatic cancer treated with chemoradiotherapy and have also been widely covered and studied in previous research. [5][6][7] In summary, clarification regarding the omissions mentioned above would greatly solidify the conclusions of the study by Dr. Lee et al 1…”

“…We read with great interest the article by Dr. Lee et al 1 This retrospective study enrolling 497 patients determined that an elevated pretreatment neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) independently and in combination significantly predicted poor overall survival and progression-free survival in patients with locally advanced pancreatic cancer treated with chemoradiotherapy. Herein, we would like to raise the following comments.…”