Post-operative AFP identifies a subset of patients at high risk of early recurrence in hepatitis b-associated hepatocellular carcinoma

Abstract

To investigate the impact of post-PNI on the postoperative survival after pancreatectomy for pancreatic cancer. Methods: A total of 346 patients who underwent pancreatectomy between January 2007 and December 2015 were included in this retrospective study. Onodera's PNI, calculated as 10adalbumin (g/dl) + 0.005adtotal lymphocyte count (per mm 3 ) was used in this study. Multivariate analysis was performed to evaluate the postoperative prognostic factors for pancreatic cancer. Relationship between pre-and intra-perioperative factors and post-PNI was investigated. Results: Multivariate analysis identified lymph node metastasis (hazard ratio (HR): 2.74, p < 0.001), lack of adjuvant chemotherapy (HR = 1.94, p < 0.001), CA19-9 value >300 U/ml (HR = 1.64, p = 0.001), and post-PNI <43 (HR = 1.48, p = 0.012) as significant prognostic factor for overall survival. Median survival time of patients with post-PNI <43 was 15.6 months, whereas that of patients with post-PNI >43 was 29.8 months, respectively. The risk factors of low post-PNI were preoperative PNI (pre-PNI) <43 (odds ratio (OR) = 4.51, p < 0.001), procedure (pancreatoduodenectomy) (OR = 4.48, p = 0.002), age >73 years old (OR = 2.55, p = 0.002), blood loss >1000 ml (OR = 20.13, p = 0.005), and dissection of nerve plexus around superior mesenteric artery (OR = 2.38, p = 0.008), respectively. Conclusion:The post-PNI (but not pre-PNI) was a significant prognostic factor of resected pancreatic cancer.