Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio in Patients After Resection for Hepato-Pancreatico-Biliary Malignancies

Background and ObjectivesWe sought to determine whether Neutrophil-lymphocyte ratio (NLR) or platelet-lymphocyte ratio (PLR) were associated with outcomes of patients undergoing surgery for a hepatopancreatico-biliary (HPB) malignancy. MethodBetween 2000 and 2013, 452 patients who underwent an HPB procedure for a malignant indication were identified. Clinicopathological characteristics, NLR, and PLR, as well as short- and long-term outcomes were analyzed. High NLR and PLR were classified using a cut-off value of 5 and 190, respectively, based on ROC curve analysis. ResultsPatients with low versus high NLR and PLR had similar baseline characteristics with regard to performance status and tumor stage (all P>0.05). Elevated PLR (HR=1.40) tends to be association with shorter recurrence-free survival (RFS) (P=0.05), whereas NLR was not a predictor of shorter RFS. Differently, both elevated NLR (HR=1.94) and PLR (HR=1.79) were associated with worse overall survival (OS) (both P<0.05). Patients with NLR 5 and those with PLR 190 had a significantly shorter OS compared to patients with NLR <5 and PLR <190, respectively (log-rank test, both P<0.05). Moreover, patients who had both NLR and PLR elevated had worse OS compared to patients with either one or none inflammatory markers elevated (log-rank P=0.02). ConclusionElevated NLR and PLR were predictors of worse long-term outcome among patients with HPB malignancy undergoing resection. J. Surg. Oncol. 2015 111:868-874. (c) 2014 Wiley Periodicals, Inc.