Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma

Abe, Toshiya; Nakata, Kohei; Kibe, Shin; Mori, Yasuhisa; Miyasaka, Yoshihiro; Ohuchida, Kenoki; Ohtsuka, Takao; Oda, Yoshinao; Nakamura, Masafumi

doi:10.1245/s10434-018-6761-6

Cited by 56 publications

(64 citation statements)

References 24 publications

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“…Ultimately, 20 studies [8,[15][16][17][18][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] including 6512 patients were enrolled in this meta-analysis after excluding ineligible studies.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…The prognostic value of mGPS has been confirmed in a variety of solid tumors, such as small cell lung cancer, colorectal cancer, gastric cancer, and ovarian cancer [11][12][13][14]. Several studies proved that mGPS was one of the most important determinants of overall survival (OS) in pancreatic cancer patients [15,16], but others showed contradictory results [17,18]. Therefore, the exactly prognostic value of mGPS remained to be confirmed.…”

Section: Introductionmentioning

confidence: 99%

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The Prognostic Value of Modified Glasgow Prognostic Score in Pancreatic Cancer: A Meta-analysis

Zhang

Ren

Jin

et al. 2020

Preprint

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Background: Several studies were conducted to explore the prognostic value of modified Glasgow Prognostic Score (mGPS) in pancreatic cancer, which reported contradictory results. The purpose of this meta-analysis was to summarize the prognostic value of mGPS in pancreatic cancer by investigating the correlation between mGPS and overall survival (OS). Methods: A systematic literature search was performed in PubMed, EMBASE, ISI Web of Science, Cochrane library databases and OVID to identify eligible studies published from Jan 1, 2011 to June 20, 2020. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were used to detect the prognostic significance of mGPS in patients with pancreatic cancer. Results: A total of 222 non-repetitive studies were identified, and 20 enrolled studies described the association between survival outcomes and mGPS in pancreatic cancer patients. The results showed a significant correlation between high mGPS and poor OS (HR=1.50, 95% CI=1.20–1.89, P<0.0001). Similar results were observed in the subgroup analyses of OS, which were based on the treatment regimen and research region. Conclusions: Our study suggested the close association between the poor prognosis and high level of mGPS, which will be helpful for future clinical applications in pancreatic cancer patients.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Modified Glasgow Prognostic Score in Pancreatic Cancer: A Meta-analysis

Zhang

Ren

Jin

et al. 2020

Preprint

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“…Numerous studies have found that malnutrition significantly increases postoperative complications and has a negative impact on the quality of life, hospital stay, anti-cancer treatment effect and overall survival in cancer patients (Borre et al, 2018;Fujiya et al, 2018;Lin et al, 2019). Furthermore, the latest research shows that there is a close relationship between nutritional status and prognosis of patients with cancer, including PDAC (Abe et al, 2018;Balzano et al, 2017;Gilliland et al, 2017). The controlling nutritional status (CONUT) score, a system for scoring immune nutritional status that emerged in 2005, has garnered the attention of researchers (De Ulibarri et al, 2005), it includes the measurement of serum albumin and total cholesterol levels as well as peripheral blood lymphocytes.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of CONUT score combined with serum CA199 levels in postoperative survival of patients with pancreatic ductal adenocarcinoma: a retrospective study

Wang

Sun

Wang

et al. 2020

PeerJ

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Background The preoperative controlling nutritional status (CONUT) score and serum carbohydrate antigen 199 (CA199) levels are individually correlated with the prognosis of pancreatic ductal adenocarcinoma (PDAC). The objective of this study aimed to investigate the efficacy of CONUT score and CA199 (CONUT-CA199) combination in predicting the prognosis of PDAC patients undergoing radical surgery. Methods We retrospectively analyzed the preoperative CONUT scores and serum CA199 levels of 294 patients with PDAC who underwent radical resection at the Affiliated Hospital of Southwest Medical University between March 2012 and July 2019. Patients were divided into four groups on the basis of their preoperative CONUT scores and serum CA199 levels: CONUTlow/CA199low (1), CONUTlow/CA199high (2), CONUThigh/CA199low (3) and CONUThigh/CA199high (4). The prognostic effects were compared among the groups. Results CONUThigh was more frequent in patients with positive peripancreatic infiltration and Clavien–Dindo classification of ≥IIIa (P < 0.001). Kaplan–Meier analysis revealed obvious difference in overall survival (OS) and recurrence-free survival (RFS) among patients with PDAC having CONUT-CA199 scores of 1, 2, 3 and 4 (P < 0.001). Peripancreatic infiltration, lymph node metastasis, pTNM stage, CONUT score, serum CA199 levels and CONUT-CA199 classification were found to be the independent prognostic factors for OS and RFS in multivariate analyses. In time-dependent receiver operating characteristic (ROC) analyses, the area of the CONUT-CA199 score under the ROC curve (AUC) was higher than that of the preoperative CONUT score or serum CA199 levels for the prediction of OS and RFS. Conclusion CONUT-CA199 classification may be more effective in predicting the postoperative prognosis of PDAC patients.

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“…(3,(7)(8)(9)(10)(11) Serum elevation of C-reactive protein (CRP), an acute-phase protein, has been shown to be a prognostic indicator in a variety of neoplasms. (12)(13)(14)(15) Moreover, hypoalbuminemia brought about by malnutrition and related to cachexia has been reported to be correlated with an unfavourable prognosis of gastrointestinal tumours. (RW.ERROR -Unable to nd reference:doc:5db2e1a0e4b044ff33679ba3) An elevated C-reactive protein-to-albumin (CRP/alb) ratio or a composite score such as the modi ed Glasgow Prognostic Score (mGPS) seem to be potentially useful biomarkers for survival, but the evidence remains controversial.…”

Section: Introductionmentioning

confidence: 99%

The ultimate preoperative C-reactive protein to albumin ratio is a prognostic factor for survival after pancreatic cancer resection

Wijk

Klein

Kanters

et al. 2020

Preprint

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Background Emerging evidence indicates that an elevated C-reactive protein-to-albumin ratio (CRP/albCAR) ratio may be associated with a poor prognosis in pancreatic ductal adenocarcinoma (PDAC). Further evidence showing that this ratio has significant prognostic value could contribute to current prediction models and clinical decision-making.Methods Data were analysed of consecutive patients who underwent curative pancreatic resection between 2013 and 2018 and were histologically diagnosed with PDAC. We investigated the relation between the ultimate preoperative CRP/albCAR ratio and overall survival.Results A total of 163 patients were analysed. Median overall survival was 18 months (IQR 9–36). Multivariate analysis demonstrated that a higher CRP/albCAR ratio (HR 1.745, P = 0.004), a higher age (HR 1.062, P < 0.001), male sex (HR 1.977, P = 0.001), poor differentiation grade (HR 2.812, P < 0.001), and positive para-aortic lymph node(s) (HR 4.489, P < 0.001) were associated with a lower overall survival. Furthermore, a CRP/albCAR ratio ≥ 0.2 was associated with decreased overall survival (16 vs. 26 months, P = 0.003). Conclusion We demonstrated that an ultimate preoperative elevated CRP/albCAR ratio is an independent indicator of decreased overall survival after resection for PDAC. The preoperative CRP/albCAR ratio may be of additional value to the current prediction models.

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Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma

Abstract: PNI in patients with surgical resection and NLR in patients with palliative surgery for PDAC may be useful prognostic factors.

Cited by 56 publications

References 24 publications

The Prognostic Value of Modified Glasgow Prognostic Score in Pancreatic Cancer: A Meta-analysis

The Prognostic Value of Modified Glasgow Prognostic Score in Pancreatic Cancer: A Meta-analysis

Predictive value of CONUT score combined with serum CA199 levels in postoperative survival of patients with pancreatic ductal adenocarcinoma: a retrospective study

The ultimate preoperative C-reactive protein to albumin ratio is a prognostic factor for survival after pancreatic cancer resection

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