Association of preoperative total lymphocyte count with prognosis in resected left‐sided pancreatic cancer

Abstract

Background: Immunologic factors such as neutrophil-lymphocyte ratio and platelet-lymphocyte ratio play an important role in predicting the oncologic outcome of patients in pancreatic ductal adenocarcinoma (PDAC). It is hypothesized that host immunity represented by total lymphocyte count at diagnostic stage would influence oncologic outcome in left-sided PDAC. Methods: Between January 1992 and August 2017, total of 112 patients who underwent distal pancreatectomy for left-sided PDAC were included and analysed. Results: At the time of the diagnosis, total lymphocyte count at diagnosis of left-sided PDAC was 1.8 AE 0.7 10 3 /μL (mean value AE standard deviation). Among different cut-off values, 1.7 showed most powerful significant differences in long-term oncologic outcomes. The patients with preoperative lymphocyte count (≤1.7) was associated with early recurrence (median 8.4 months versus 18.1 months, P = 0.011) and shorter survival (median 18.6 months versus 35.9 months, P = 0.028). Patients with preoperative total lymphocyte count over 1.7 showed higher white blood cell count (P < 0.001), platelet count (P = 0.039), neutrophil count (P = 0.004) and monocyte count (P = 0.001). However, more interestingly, neutrophil-lymphocyte ratio (P < 0.001) and platelet-lymphocyte ratio (P < 0.001) were found to be significantly higher in those with total lymphocyte count less than 1.7. Lymphocyte to monocyte ratio was inversely related to preoperative total lymphocyte count (P < 0.001). Only age was identified to be significantly different (P = 0.007). However, other clinicopathological parameters generally known to be related to tumour aggressiveness, were not different between two groups. Conclusion: In conclusion, preoperative total lymphocyte at diagnostic stage is simple, and good prognostic factor in left-sided pancreatic cancer.

Additive Value of Preoperative Sarcopenia and Lymphopenia for Prognosis Prediction in Localized Pancreatic Ductal Adenocarcinoma

“…The use of a threshold offered better discrimination than the use of lymphocyte count because it allows relapse-risk stratification. Both lymphocyte count and NLR are recognized independent prognostic factors in pancreatic adenocarcinoma and are used in clinical practice (24,25).…”

Preoperative Lymphocyte-to-Monocyte Ratio as a Predictor of Prognosis in Patients who Underwent Resection of Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus

“…Lymphocytes in the peripheral blood display anti-tumor activity by supporting host defense 24 . High lymphocyte numbers are signi cantly associated with favorable clinical outcomes in several types of cancer [25][26][27] . High levels of lymphocytic attractant chemokines, such as gamma-interferon inducible protein-10 and monokine induced by gamma-interferon, can predict a favorable prognosis in RCC patients 28 .…”

Value of the preoperative prognostic nutritional index for the evaluation of patient prognosis after radical gastrectomy

“…Ouyang et al (28) showed that preoperative serum albumin levels are associated with prognosis in patients with GC. The immune response of lymphocytes to the tumor has been gradually applied to the prognostic evaluation of tumor patients in recent years (29). The PNI has been used recently for the prognostic evaluation of various tumors, including colorectal cancer (30), liver cancer (31), and pancreatic cancer (32).…”