4.3 Article

Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil-lymphocyte and platelet-lymphocyte ratios

Journal

SURGERY TODAY
Volume 46, Issue 5, Pages 583-592

Publisher

SPRINGER
DOI: 10.1007/s00595-015-1206-3

Keywords

Pancreatic ductal adenocarcinoma; Borderline resectable pancreatic ductal adenocarcinoma; Prognostic factor; Neutrophil-lymphocyte ratio; Platelet-lymphocyte ratio

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The therapeutic strategy for borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) has remained unestablished because the preoperative prognostic factors have not been determined. One hundred eighty-four consecutive PDAC patients who underwent upfront surgery with a curative resection between January 2000 and June 2013 at Kobe University Hospital were retrospectively studied. The PDAC patients were stratified into resectable (R)-PDAC (n = 147) and BR-PDAC patients (n = 37). We evaluated the independent prognostic significance of the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) in the BR-PDAC patients. BR-PDAC patient survival was significantly worse than R-PDAC patient survival (median survival time: 22.1 months vs. 24.3 months; 5-year survival rate 6 vs. 21 %; P = 0.042). The median survival in BR-PDAC patients with a preoperative NLR of > 3 (n = 12) was 10.2 months, while that in patients with preoperative NLR of a parts per thousand currency sign3 (n = 25) was 24.9 months (P = 0.002). Moreover, the median survival in BR-PDAC patients with a preoperative PLR of > 225 (n = 8) was 10.2 months, while that in patients with a preoperative PLR of a parts per thousand currency sign225 (n = 29) was 24.7 months (P = 0.003). Preoperative NLR > 3 (HR = 2.980, 95 % CI 1.251-6.920; P = 0.015) and PLR > 225 (HR = 3.050, 95 % CI 1.169-7.468; P = 0.024) were independent prognostic factors in BR-PDAC patients. Higher preoperative NLR and PLR can be independent predictive risk factors in BR-PDAC patients following curative resection.

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