Ratio neutrophils lymphocytes as a prognosis marker in pancreatic cancer

Abstract

s / Pancreatology 15 (2015) e1ee17 e5 disease received 5 weeks therapy with 250 mg/m2/d 5-FU infusion and concomitant radiotherapy (50.4 Gy). Patients included in the clinical trial received gemcitabine 40 mg/m2 twice a week and erlotinib 100 mg/ d during radiotherapy treatment. After new re-staging withMDTC, pts that did not progress underwent surgical resection. Results: Disease progression precluded surgery in 11 pts (50%). Eleven pts (50%) underwent pancreatectomy: pancreaticoduodenectomy (9), distal pancreatectomy (1) and total duodenopancreatectomy (1). Partial vascular resection (venous or arterial) was necessary in 7 cases. Seven of the resected tumors (63%) had negativemargins. Only one tumorwas node positive and there were 3 complete pathological responses. There was no in-hospital or 30-daymortality. Four pts needed re-operation. Of the 11 pts who completed all therapy, 4 are alive, including 1 without evidence of disease. Themedian overall survival (OS) for all pts was 14mo (95% CI 9.2918.7). Median OS for pts who underwent surgery was 30.4 mo (95%CI 14.446.3) and 10.9 mo (95% CI 7.8-13.9) for those patients in whom candidate to surgery was excluded (p<0.0001).Conclusion: Neoadjuvant treatment of ADKP -BR selects a group of patients in whom the resection achieves a significantly higher survival than in the group with disease progresion during progresion during neoadjuvant treatment. Most of the patients aimed for pancreatic resection after neoadjuvant therapy required also vascular resection.