Abstract
186 Background: Several previous studies reported neutrophil-to-lymphocyte ratio (NLR) could be a promising prognostic factor for patients with cancer. We aimed to determine the prognostic value of NLR in patients with advanced pancreatic cancer (APC) following palliative chemotherapy. Methods: We retrospectively reviewed 253 consecutive APC patients receiving palliative chemotherapy between January 2006 and December 2012. We classified the patients according to the pretreatment NLR values (≤5 or >5) into two groups and investigated the difference in treatment outcomes, including time to treatment failure (TTF) and overall survival (OS); and also analyzed the impact of NLR kinetics after one cycle of chemotherapy on the treatment outcomes. Results: A total of 213 patients had pretreatment NLR values of ≤5 (group A), while 40 patients had an NLR of >5 (group B). TTF and OS were significantly shorter in group B than in group A (3.1 vs. 6.0 months and 8.8 vs. 12.8 months, respectively). After adjustment for putative prognostic factors, including distant metastasis, status of recurrent/unresectable disease, pretreatment carbohydrate antigen 19-9 levels, carcinoembryonic antigen levels, and C-reactive protein levels, using the Cox regression model, elevated pretreatment NLR remained an independent poor prognostic factor for OS (hazard ratio, 1.95; 95% confidence interval, 1.29–2.95; P <0.01). In addition, patients in group B whose NLR dropped to ≤5 before the second cycle of chemotherapy showed longer TTF and OS compared with those whose NLR remained at >5. Conclusions: Our results support the idea that NLR can be a promising prognostic and predictive marker for APC patients receiving palliative chemotherapy.
Highlights
Pancreatic cancer is one of the most lethal malignancies worldwide [1], and most patients are diagnosed too late for curative resection
Cancer Medicine published by John Wiley & Sons Ltd
Growing evidence supports a positive relationship between inflammation and cancer development and progression [5, 6]
Summary
Pancreatic cancer is one of the most lethal malignancies worldwide [1], and most patients are diagnosed too late for curative resection. Disease relapse within 2 years occurs in >80% patients [2, 3]. Systemic gemcitabine-based chemotherapy has long been used as a standard therapy for patients with advanced pancreatic cancer (APC). The long-term efficiency and prognosis vary greatly among patients [4]. It is clinically relevant to identify APC patients who are more likely to benefit from palliative chemotherapy. Cancer Medicine published by John Wiley & Sons Ltd. Cancer Medicine published by John Wiley & Sons Ltd
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