Preoperative platelet‑lymphocyte ratio is an independent prognostic factor in ampullary carcinoma following pancreaticoduodenectomy

Wang, Wen-Qin; Liu, Wei; Zhang, Ning; He, Xiaodong

doi:10.3892/ol.2018.9285

Cited by 7 publications

(12 citation statements)

References 57 publications

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“…However, there was no significant difference between groups in regard to lymph node metastasis. This result suggests that the preoperative PLR correlates in all patients with evidence of local invasion of the resected ampullary carcinoma; this finding is consistent with previous reports (30)(31)(32).…”

Section: Discussionsupporting

confidence: 92%

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Stratification of Prognosis in Patients With Ampullary Carcinoma After Surgery by Preoperative Platelet-to-lymphocyte Ratio and Conventional Tumor Markers

et al. 2019

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Background/Aim: The platelet-to-lymphocyte ratio (PLR) has recently been suggested as a new predictor of the prognosis in several carcinoma types. However, the clinical impact remains controversial in patients with ampullary carcinoma. Thus, the aim of this study was to investigate other useful biomarkers for identifying poor prognosis in patients with ampullary carcinoma. Patients and Methods: Forty-one patients with ampullary carcinoma underwent pancreaticoduodenectomy (PD) with curative resection between April 2000 and April 2017. Various clinicopathological findings of the patients and their tumors were evaluated as potential prognostic factors which might enable better stratification of prognosis. Results: Platelet-to-lymphocyte ratio, as well as other markers, was found to be a prognostic factor in patients with ampullary carcinoma. The 2-year disease-free survival percentage was significantly higher in the group with low PLR than in the high PLR group (70.2% vs. 28.6%; p=0.005) . Combinational analysis of the PLR and conventional TMs enabled us to stratify prognosis of the patients more clearly than by each marker alone. Conclusion: PLR was a useful prognostic factor for patients with ampullary cancer. The combination of preoperative PLR and conventional TMs markers may be powerful predictive factors for postoperative prognosis in patients with ampullary carcinoma following PD.Ampullary carcinoma is extremely rare, accounting for approximately 0.2-0.5% of all gastrointestinal malignancies and approximately 6-17% of periampullary tumors (1-4). The most commonly recommended treatment is pancreaticoduodenectomy (PD), which has a reported resectability rate of 82.1% (1). Although ampullary carcinoma is considered to have a better prognosis [5-year survival rate of 30% to 60% (1, 5, 6)] than other peripancreatic head adenocarcinomas, some cases have a poor prognosis with early recurrence.Several prognostic factors have been reported in ampullary carcinoma, including lymph node metastasis (1, 7-10), depth of tumor infiltration (2, 9), tumor stage (3, 10), involvement of resection margins (5), lymphatic vessel invasion (7), perineural invasion (8), and pancreaticobiliary subtype (4, 10, 11). However, accurate information for these factors are generally obtained postoperatively.In recent years, biomarkers have been suggested as new prognostic factors in several cancer types. Of these, the lymphocyte-to-monocyte ratio (LMR), neutrophil-tolymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) have been studied extensively and adopted as predictors of prognosis in other diseases (12-25). However, in ampullary carcinoma, the roles of these biomarkers remain controversial, as the presence of this disease is relatively rare and blood-based biomarkers may be affected by comorbidities, such as obstructive jaundice and cholangitis.Based on this, we evaluated preoperative LMR, NLR, and PLR as prognostic factors for ampullary carcinoma in patients free of obstructive jaundice and cholangitis. Furthermore, in order to...

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Section: Discussionsupporting

confidence: 92%

“…These results suggest that PLR may reflect tumorrelated host systemic immune responses. While the most suitable cutoff value of PLR is unknown, the values reported here are similar to those of previous report (32).…”

Section: Figure 2 the 2-year Disease-free Survival (Dfs) Rates Accord...supporting

confidence: 89%

Stratification of Prognosis in Patients With Ampullary Carcinoma After Surgery by Preoperative Platelet-to-lymphocyte Ratio and Conventional Tumor Markers

et al. 2019

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“…A series of scores based on in ammatory factors have been used as convenient and feasible prognostic indicators for various malignant tumors in the past decade (22)(23)(24) . However, due to the rareness of ampullary carcinoma and the possibility of being affected by coexisting diseases, such as obstructive jaundice and cholangitis, the predictive value of these in ammation-based scores is less reliable (1,(12)(13)(14)19) . This study is the rst attempt to use this prognostic indicator of CA19-9 to GGT ratio to predict the prognosis and survival of patients with ampullary carcinoma after radical resection.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In the past decade, the in ammation-based scores have emerged as novel prognostic indexes for a variety of malignant tumors (12)(13)(14)(15)(16)(17)(18)(19)(20) , such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and has been favored by more and more scholars. However, the predictive value of these in ammation-based scores remains controversial (12)(13)(14)19) . In view of the above considerations, CA19-9/GGT ratio was used to evaluate whether it will become a simple, accessible, and more predictive prognostic indicator for AC patients after radical resection.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma

Chen

Zhang

Jia

et al. 2022

Preprint

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BACKGROUND AND AIMS: In recent years, more and more inflammatory indicators have been studied to predict the long-term survival of patients with ampullary carcinoma (AC) after radical resection, but these prognostic indicators are still controversial. Therefore, based on previous inflammation scores, this study established a novel, easily accessible, more feasible and more predictive prognostic marker [Carbohydrate antigen199 to gamma-glutamyltransferase ratio (CA19-9/GGT)] to better assess the prognostic significance in AC patients undergoing radical resection. METHODS: Overall survival (OS) and recurrence-free survival (RFS) were analyzed by Cox regression model. Correlation between CA19-9/GGT and clinicopathological variables were analyzed by Chi-squared test, Fisher ' s exact test, independent sample t test and Mann-Whitney U test. The performance of prognostic indexes is compared by the consistency index (C-index). The prediction accuracy of nomogram is further confirmed by calibration curve and decision curve analysis (DCA). RESULTS: CA19-9/GGT was an independent risk factor affecting OS [P = 0.001, hazard ratio (HR) = 2.459, 95% confidence intervals (CI): 1.450–4.167] and RFS (P = 0.002, HR = 2.333, 95% CI: 1.371–3.971) in multivariate analysis. The optimal cut-off value of CA19-9/GGT was 0.14. In CA19-9/GGT correlation analysis, high risk group (> 0.14) was significantly associated with poor prognosis. The predictive performance of CA19-9/GGT (OS: C-index = 0.753, RFS: C-index = 0.745) was confirmed to be superior to other prognostic indicators according to the C-index. Compared with the simple AJCC staging system, the Nomogram prediction model (OS: C-index = 0.787, RFS: C-index = 0.795) established by the combination of CA19-9/GGT and AJCC 8th TNM staging system has higher prediction accuracy. CONCLUSIONS: CA19-9/GGT was an independent prognostic indicator after radical resection of AC. Incorporating CA19-9/GGT into the AJCC TNM staging system optimized the prediction accuracy of the TNM staging system, and further verified the predictive value of CA19-9/GGT.

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Prognostic Impact of Indicators of Systemic Inflammation and the Nutritional Status of Patients with Resected Carcinoma of the Ampulla of Vater: A Single‐Center Retrospective Study

et al. 2021

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Background Several indicators of systemic inflammation and nutritional status were recently shown to serve as novel prognostic factors for certain cancers. Here, we aimed to investigate the prognostic impact of preoperative indicators of systemic inflammation and nutritional status associated with the survival of patients with resected ampulla of Vater carcinoma (AC). Methods We retrospectively analyzed the records of 91 patients who underwent pancreatoduodenectomy (PD) for AC from January 2002 through December 2018. Indices for systemic inflammation and nutritional status (Systemic immune-inflammation index [SII], Prognostic nutritional index [PNI], modified Glasgow prognostic score [mGPS], and Controlling nutritional status score [CONUT]) were determined using preoperative blood tests. Clinicopathological factors and these indices were analyzed to identify predictors of overall survival (OS). ResultsThe median preoperative SII and PNI values were 456.7 and 47.5, respectively, and their optimal cut-off values were 670.0 and 50.0, respectively. Univariate analysis revealed that high SII, low PNI, mGPS C 1, and malnutrition, assessed using the CONUT, were significant predictors of shorter OS. Multivariate analysis revealed that high SII (HR = 2.71, p = 0.023) and malnutrition assessed using the CONUT (hazard ratio = 3.98, p = 0.006) were independent predictors of shorter OS. Conclusion SII and the CONUT predicted the survival of patients with AC after radical resection. These indicators are easily calculated using preoperative blood tests and may contribute to the development of improved strategies to treat AC.

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Preoperative platelet‑lymphocyte ratio is an independent prognostic factor in ampullary carcinoma following pancreaticoduodenectomy

Cited by 7 publications

References 57 publications

Stratification of Prognosis in Patients With Ampullary Carcinoma After Surgery by Preoperative Platelet-to-lymphocyte Ratio and Conventional Tumor Markers

Stratification of Prognosis in Patients With Ampullary Carcinoma After Surgery by Preoperative Platelet-to-lymphocyte Ratio and Conventional Tumor Markers

Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma

Prognostic Impact of Indicators of Systemic Inflammation and the Nutritional Status of Patients with Resected Carcinoma of the Ampulla of Vater: A Single‐Center Retrospective Study

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