The prognostic efficacy of albumin, CA19-9 and NLR for pancreatic cancer patients who underwent neoadjuvant chemoradiotherapy

Abstract

Introduction: Numerous studies examined the prognostic factors for pancreatic cancer, but in neoadjuvant setting, the utilities of these markers are fully unknown. We hypothesis that the combination of post-treatment serum albumin, CA19-9 and NLR will be a reliable prognostic score for patients with pancreatic cancer through neoadjuvant chemoradiotherapy. Method: Sixty-one patients who managed in our hospital during 2003 to 2017 were reviewed in this analysis. In our institute, NACRT usually comprises 5-FU (300 mg/body/day) or TS-1 60mg/m2/d, cisplatin (10mg/body), mitomycin C (4mg/body/day,), heparin (6000 IU/body/day, and radiation (total 40 Gy). Cut-off value was set as 3.9g/dL for ALB, 40IU/mL for CA19-9 and 5.0 for NLR, respectively. We examined whether these makers and score are associated with overall survival(OS) in all patients and patients with subsequent surgery. Result: The mean age was 66.7±8.0, 75.4% were male patients. Forty-three patients underwent subsequent surgery with curative intent and 81.3% of patients had R0 resections. In case that low ALB, high CA19-9 and high NLR were assigned a value of 1, a log-rank test showed statistically significant difference in OS between each score in in both all patients and resected patients (all patients; 3vs2vs1vs0 3year survival rate 0/34.9/58.1/92.3%, 5year survival rate 0/0/50.9/71.8%, p< 0.001, resected patients; 3year survival rate 0/33.3/68.6/92.3% 5year survival rate 0/0/68.6/71.8%, p< 0.001). Conclusion: Concise prognostic score in the combination of post-treatment albumin, CA19-9 and NLR is likely to be useful.