Abstract

BackgroundWe retrospectively investigated the prognostic value of pre-treatment advanced lung cancer inflammation index (ALI) in locally advanced pancreatic carcinoma (LAPC) patients who underwent concurrent chemoradiotherapy (CCRT). MethodsPresent retrospective cohort analysis incorporated consecutive 141 LAPC patients who received radical CCRT. Accessibility of baseline ALI cutoff(s) impacting survival outcomes was sought by receiver operating characteristic (ROC) curve analysis. Interaction between the ALI and overall- (OS) and while progression-free survival (PFS) constituted our primary and secondary end points, respectively. ResultsAt a median follow-up of 14.4 months (range: 3.2-74.2), the median PFS and OS were 7.5 (%95 CI: 5.9-9.1) and 14.6 months (%95 CI: 11.6-17.6), respectively. ROC curve analyses set the ideal ALI cutoff value at 25.3 (AUC: 75.6; sensitivity: 72.7%; specificity: 70.3%) that exhibited a significant association with both the OS and PFS results. Patient stratification into two groups per ALI [≤25.3 (N = 75) versus >25.3 (N = 66)] showed that the ALI>25.3 group had a significantly superior median OS (25.8 versus 11.4 months; P < 0.001) and PFS (15.9 versus 6.0 months; P < 0.001) than its ALI≤25.3 counterpart. Other factors exhibiting significantly better OS and PFS rates were N0(versus N1) stage (P < 0.05 for each endpoint) and CA 19-9 ≤90 U/mL (versus >90 U/mL), respectively (P < 0.05 for each end point). These three factors were also affirmed to be independent indicators of longer OS and PFS (P < 0.05 for each) in multivariate analyses. ConclusionsResults of this hypothesis-generating research proposed the pre-CCRT ALI as a novel robust associate of OS and PFS outcomes for LAPC patients undergoing CCRT. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

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