The relation between inflammation-based parameters and survival in metastatic pancreatic cancer.

Abstract

We aimed to evaluate whether tumor markers and inflammation parameters effect on survival in patients with metastatic pancreatic cancer (MPC). This retrospective analysis included 170 patients with pancreatic cancer who were admitted to the oncology clinic at the metastatic stage. Basic patient demographic characteristics, chemotherapy (CT) that patients received in the first line, complete blood count, neutrophil/lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), albumin/globulin ratio (AGR), prognostic nutritional index (PNI), tumor markers (carcinoembryonic antigen [CEA], carbohydrate antigen 19-9 [CA19-9]), and survival were analyzed. Receiver operating characteristic analysis was used to determine the optimum cutoff value of NLR, PLR, AGR, PNI, CEA, and CA 19-9, which could predict survival. The median age of the patients was 63 years (range, 33-87). About 63.5% of the patients were male and 44.5% were female. 161 (94.7%) patients died, and the median overall survival (OS) was 8.0 months (95% confidence interval = 6.6-9.4) for all patients. In univariate analysis, age (P < 0.001), CT regime (P < 0.002), AGR (P < 0.006), PNI (P < 0.017), NLR (P < 0.001), PLR (P < 0.062), and CA19-9 (P < 0.002) were statistically significant. In multivariate analysis, age (hazard ratio [HR] 1.534 95% 1.079-2.182 P < 0.017) CA19-9 (HR1.410 95% 1.001-1.989, P ≤0.005) and, NLR (HR 1.569 95% 1.001-2.463, P < 0.049) were significant. We determined, age, CA19-9, and basal high NLR as independent adverse prognostic factors for OS in APC. Fluorouracil, leucovorin, irinotecan, and oxaliplatin CT resulted in a significant increase in OS.