Y. Shirai1, H. Shiba1, T. Horiuchi1, R. Iwase1, K. Haruki1, K. Abe1, Y. Fujiwara1, K. Furukawa1, S. Onda1, D. Hata1, T. Sakamoto1, Y. Futagawa1, Y. Toyama1, Y. Ishida1, K. Yanaga1 1The Jikei University School Of Medicine,Department Of Surgery,Tokyo, TOKYO, Japan
Introduction
Pancreatic cancer is one of the most common digestive cancers, and only 10-20% are operable disease. There are several prognostic indices such as tumor size, nodal involvement, resection margin status, and tumor differentiation. However, preoperative estimation of oncological prognosis remains to be established. In several reports, preoperative platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) are significant prognostic indicators in digestive malignancies. The objective of this study was to evaluate whether preoperative PLR or NLR is a significant prognostic index in resected pancreatic invasive ductal adenocarcinoma.
Methods
A total of 131 patients who underwent pancreatic resection for pancreatic invasive ductal adenocarcinoma were available from prospective maintained database. The patients were divide into two groups as PLR <150 or ≥150, and as NLR <5 or NLR ≥5, respectively. Survival data were analyzed using the Log-rank test for univariate analysis and Cox proportional hazards for multivariate analysis. P value <0.05 was judged as significant.
Results
The preoperative PLR was a significant prognostic index by Kaplan-Meier and Log rank tests. The median Overall Survival in patients with PLR <150 was 38.6 months, which was significantly better than 17.6 months for PLR ≥150 (p=0.001). The PLR retained its significance on multivariate analysis (HR, 1.688; 95 % CI, 1.045–2.726; p = 0.032) along with tumor size (p=0.035), resection margin status (p=0.048), and tumor differentiation (p=0.002).
Conclusion
The preoperative PLR is a significant independent prognostic index in resected pancreatic invasive ductal adenocarcinoma.