Neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, neutrophil–platelet score and prognostic nutritional index: do they have prognostic significance in metastatic pancreas cancer?

Doğan, Mutlu; Algın, Efnan; Güven, Zeynep Tuğba; Baykara, Meltem; Köş, Tuğba; Bal, Öznur; Zengi̇n, Nurullah

doi:10.1080/03007995.2017.1408579

Cited by 23 publications

(19 citation statements)

References 26 publications

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“…In our study, initial NLR was significantly lower in LS patients with mPDAC. Those results are consistent with previous studies as the prognosis role of the NLR has been demonstrated in PDAC in both early and advanced stages . NLR should be considered a stratification factor in further clinical trials in order to determine whether patients with high NLR at diagnosis could benefit from intensified treatment or, on the contrary, should only require palliative treatment.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survivors in Metastatic Pancreatic Ductal Adenocarcinoma: A Retrospective and Matched Pair Analysis

et al. 2019

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Background. Metastatic pancreatic ductal adenocarcinoma (mPDAC) is an aggressive malignancy with a median overall survival (OS) of between 8 and 11 months. However, a significant number of patients experience a longer survival, more than 18 months. The aim of this study was to describe the "long-term survivor" population and to evaluate clinical and pathological factors that might affect survival. Materials and Methods. All patients with mPDAC diagnosed in the Centre Leon Bérard (Lyon, France) between January 2010 and June 2015 and who survived more than 18 months were identified. They were compared with a control cohort matched on age, sex, performance status, stage at diagnosis, primary tumor localization, treatment, and liver metastasis. Their clinical features, treatment modalities, and outcomes were analyzed. Results. A total of 94 patients were included, 47 in each cohort. Both cohorts had identical characteristics as follows: women (51%), performance status ≤1 (95.7%), median age at diagnosis (60 years), and metastasis at diagnosis (83%). Median OS was 26.87 months (95% confidence interval [CI] 23-31.08) in the long-term survivor group (LS group) and 9.79 months (95% CI 5.75-11.86) in the control group (C group). Potential factors of long-term survival were explored with a logistic model (LS group vs. C group). Three factors were identified as significant prognostic factors in the univariate analysis: lymphopenia (odds ratio [OR] ref: yes = 0.26), neutrophil-to-lymphocyte ratio (NLR; OR ref >5 = 0.31), and peritoneal carcinomatosis (OR ref: yes = 0.40). NLR was the only remaining factor in our backward selection procedure. Conclusion. A significant subset of patients with mPDAC can achieve long-term survival (≥18 months) in 2018. We identified low NLR as a significant prognostic factor associated with longterm survival in mPDAC. The Oncologist 2019;24:1543-1548 Implications for Practice: Metastatic pancreatic ductal adenocarcinoma (mPDAC) is one of the most lethal types of cancer. A subset of patients with mPDAC can achieve long-term survival (≥18 months) with a modern chemotherapy regimen, such as FOLFIRINOX or gemcitabine/nab-paclitaxel. We identified low neutrophil-to-lymphocyte ratio (NLR) as a significant prognostic factor associated with long-term survival in mPDAC. Prognostic factors such as NLR might allow accurate selection of patients with mPDAC in order to consider individual therapeutic approaches. NLR should be used as a stratification factor in clinical trials.

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Section: Discussionmentioning

confidence: 99%

Long-Term Survivors in Metastatic Pancreatic Ductal Adenocarcinoma: A Retrospective and Matched Pair Analysis

et al. 2019

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“…It is worth noting that previous authors acknowledged the limitations of their meta-analyses and weakness due to intrinsic heterogeneity, including but not limited to small sample size, variability in cut off levels used, variation in demographic patient population, difference in interventions, large spectrum of clinical stage included, endpoint criteria, and retrospective nature of study (10,26). Most importantly there is a recognized publication bias due to inclusion of studies with positive results and possible exclusion of non-published negative results (29,30) Therefore, we urge caution when evaluating both (NLR and PLR) novel biomarkers from our retrospective review of resectable pancreatic adenocarcinoma patients in order to avoid potential controversy.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios inversely correlate to clinical and pathologic stage in patients with resectable pancreatic ductal adenocarcinoma

Recio-Boiles¹,

Nallagangula

Veeravelli³

et al. 2019

Ann Pancreat Cancer

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Background: Post-surgical pathology (SP) staging correlates with long-term survival. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been shown to predict prognosis and extent of tumor in patients with metastatic pancreatic ductal adenocarcinoma (PDAC). This study aimed to correlate NLR and PLR to radiological clinical staging (CS), carbohydrate antigen (CA) 19–9 tumor marker and SP staging in patients with resectable-PDAC (R-PDAC); and to investigate NLR and PLR as potential markers to guide neoadjuvant therapy. Methods: Data were collected retrospectively from R-PDAC patients who received upfront surgery from November 2011 to December 2016. NLR and PLR values on the day of diagnosis and surgery were collected. SP, tumor size, location, resected margins (RM), lymphovascular/perineural invasion (LVI/PNI), lymph node involvement, and AJCC/TNM 8th Edition staging were obtained. Associations were assessed using linear, ordinal logistic, and poison regressions or Kruskal Willis Rank Sum Test per the nature of outcome variables, with statistical significance at p-value <0.05. Results: Fifty-five patients were identified with resectable stage I (61%) and II (38%). They had a mean age of 66 years (48–87 years) and were 47.2% male, 83.6% white, 90.9% non-Hispanic and 89% with ECOG 0–1. NLR/PLR at diagnosis for R0, R1 and R2 were 6.7/241, 4.8/224, and 2.9/147 (P=0.01/0.002), respectively. NLR/PLR for N0 and N1 were 5.1/212 and 2.7/138.3 (P=0.03/0.009) at diagnosis. No other significant association was detected. Conclusions: These findings suggest that NLR/PLR inversely correlates with RM and lymph node status in patients with R-PDAC, but require prospective evaluation in clinically defined scenarios.

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“…In the patients with malignant tumours, systemic inflammatory response plays a crucial role in the development and progression of tumours [7][8][9][10][11][12][13][14][15][16][17][18][19][20]. On the other hand, nutritional status has a significant role in the prognosis of these patients [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

The Usefulness of Prognostic Nutritional Index in Predicting Infection in Patients with Newly Diagnosed Pancreatic Cancer

Manojlovic

2021

BJSTR

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Background/Aims: Data on the usefulness of prognostic nutritional index (PNI) in predicting infection in patients with pancreatic cancer before oncological treatment are limited. The aim of this study was to investigate the usefulness of PNI in predicting infection in patients with newly diagnosed pancreatic cancer. Methods:The retrospective study included 59 adult patients. We recorded clinicopathological characteristics and laboratory analysis on admission and infectious complications that occurred during hospitalization. PNI was calculated using albumin and lymphocyte count. Association with infective complication was tested for the age, sex, body mass index, albumin levels, lymphocyte count, PNI, PNI<40.5, serum carbohydrate and carcinoembryonic antigen, tumour location, the existence of metastases and hospitalization length.Results: In the analysed series, there were 36 (61%) male and 23 (39%) female patients; mean age was 62.5 years. Infectious complications were detected in 25 (42,4%) patients. Three factors were found to be associated with infectious complications (Binary logistic regression): serum albumin level (P=0.019), PNI (P=0.030) and PNI below 40.5 (P=0.026). ROC curve analysis determined PNI=39.5 as a new cut-off value for the occurrence of complications, but with relatively low sensitivity (40%) and specificity (38.2%). Conclusion:Low serum albumin concentration and PNI could represent risk factors for infection in patients with newly diagnosed pancreatic cancer.

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Neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, neutrophil–platelet score and prognostic nutritional index: do they have prognostic significance in metastatic pancreas cancer?

Abstract: Basal high NLR (>3), advanced age (>60 years), poor ECOG-PS (>2) and cholestasis were independent poor prognostic factors in MPC. However, PNI, NPS and PLR had no prognostic significance (p = .51, p = .86 and p = .062, respectively).

Cited by 23 publications

References 26 publications

Long-Term Survivors in Metastatic Pancreatic Ductal Adenocarcinoma: A Retrospective and Matched Pair Analysis

Long-Term Survivors in Metastatic Pancreatic Ductal Adenocarcinoma: A Retrospective and Matched Pair Analysis

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios inversely correlate to clinical and pathologic stage in patients with resectable pancreatic ductal adenocarcinoma

The Usefulness of Prognostic Nutritional Index in Predicting Infection in Patients with Newly Diagnosed Pancreatic Cancer

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