Abstract
Abstract Purpose: We evaluated the clinical importance, such as the occurrence of postoperative pancreatic fistula (POPF) or prognosis, of preoperative serum markers of chronic inflammation, nutrition, and immunity, as well as that of serum tumor markers after curative resection of pancreatic ductal adenocarcinomas (PDACs). Methods: Between 2006 and 2015, 43 patients with PDACs underwent curative resection at Tottori Prefectural Central Hospital. We analyzed which preoperative indicators (i.e., C-reactive protein/albumin ratio [CAR], neutrophil/lymphocyte ratio [NLR], prognostic nutritional index [PNI], carcinoembryonic antigen [CEA], and carbohydrate antigen 19-9 [CA 19-9]) were the most relevant risk factors for occurrence of POPF and poor patient survival. Results: POPF was detected in 8/43 (18.6%) patients. One patient died of pancreatic fistula at 2 months postoperatively. Among nine candidate factors (operative procedure, operation time, tumor stage, preoperative serum amylase, preoperative CAR, NLR...
Highlights
The prognosis of patients with pancreatic ductal adenocarcinomas (PDACs) is extremely poor
The reference ranges of C-reactive protein/albumin ratio (CAR), Neutrophil/lymphocyte ratio (NLR), and prognostic nutritional index (PNI) were determined by investigating the preoperative CAR, NLR, and PNI in 147 patients who underwent radical inguinal hernia operations from 2012 to 2015 at our hospital
To determine the cutoff values corresponding to the CAR, NLR, and PNI, we plotted receiver operating characteristic (ROC) curves for the 147 control patients and 43 patients with PDACs
Summary
The prognosis of patients with pancreatic ductal adenocarcinomas (PDACs) is extremely poor. Sato et al.[5] reported that in patients with resected PDACs in Japan, the estimated 5-year diseasespecific survival rate was 23.1%, and the disease-free survival (DFS) rate was 16.8%. Neutrophil/lymphocyte ratio (NLR) and prognostic nutritional index (PNI) are markers of chronic systemic inflammation and the patients’ immune status and nutritional condition.[15,16] serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) levels are known to be good progression indicators among patients with PDACs, including followup after resection of tumors.[1,17]. We evaluated the prognostic and clinical importance of serum markers of chronic inflammation, nutrition, and immunity combined with tumor markers of patients with PDACs
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