Abstract
Background: Pancreatic cancer is the fourth leading cause of cancer death, and its prognosis remains poor despite recent advances in treatment. Our goal was to determine prognostic factors associated with pancreatic cancer outcome by retrospective analysis of the clinical characteristics and follow-up data of patients who received palliative or curative surgical treatment. Methods: In this retrospective study, we analyzed the medical records and follow-up information of 344 pancreatic cancer patients who received curative or palliative surgical treatment at a tertiary care referral center in Greece from January 2004 to December 2015. The overall survival (OS) and disease free survival (DFS) rates were determined by the Kaplan- Meier method and univariate analysis was conducted to identify potential prognostic factors. Multivariate analysis, using the Cox proportional hazards model, was conducted to define independent prognostic factors. Results: Among the 344 patients with resectable tumors in the study cohort, 226 and 118 patients, respectively, underwent curative and palliative surgical resection. The median survival after curative resection was statistically higher compared to palliative resection (23.129 vs. 5.025months, p<0.05). The estimated 1-, 3-, and 5-year OS rates after curative resection were 35.84%, 15.48%, and 6.19% respectively. Univariate and multivariate analyses identified the following independent prognostic factors for OS: microvacular invasion, neutrophil to lymphocyte ratio (NLR), modified Glasgow prognostic score (mGPS) and lymph node ratio (LNR). Additionally, microvascular invasion, NLR >5 and PLR >160 were independent prognostic factors for DFS. Conclusion: Surgery remains the only curative therapy in pancreatic cancer treatment. Inflammation markers and LNR should be thoroughly assessed as independent prognostic factors in pancreatic cancer patients
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