Neutrophil-to-lymphocyte ratio predicts metachronous liver metastasis of pancreatic neuroendocrine tumors

  • Kota Arima
  • Hirohisa Okabe
  • Daisuke Hashimoto
  • Akira Chikamoto
  • Hidetoshi Nitta
  • Takaaki Higashi
  • Takayoshi Kaida
  • Kensuke Yamamura
  • Yuki Kitano
  • Yoshihiro Komohara
  • Yo-ichi Yamashita
  • Toru Beppu
  • Motohiro Takeya
  • Hideo Baba
Original Article

DOI: 10.1007/s10147-017-1111-4

Cite this article as:
Arima, K., Okabe, H., Hashimoto, D. et al. Int J Clin Oncol (2017). doi:10.1007/s10147-017-1111-4
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Abstract

Background

Pancreatic neuroendocrine tumors (PNETs) are clinically malignant, having metastatic potential. Histological tumor grade is an accepted indicator of malignant potential, but noninvasive prognostic markers have not yet been identified. This study assessed whether the preoperative neutrophil-to-lymphocyte ratio (NLR) could predict clinical outcomes of PNET patients.

Methods

Fifty-eight patients who underwent curative resection for PNETs between 2001 and 2015 were retrospectively evaluated. The correlations between the preoperative NLR and clinicopathological parameters, including patient baseline clinical characteristics, tumor progression, and postoperative oncological outcome were evaluated.

Results

A high preoperative NLR was significantly associated with large tumor size (P = 0.0015) and high tumor grade (P < 0.0001). Overall survival and relapse-free survival of patients with a high NLR (≥2.4) were significantly shorter than those of patients with a low NLR (<2.4, P = 0.0481 and P < 0.0001, respectively). Multivariate analysis revealed that NLR ≥2.4 and tumor size ≥2 cm were independent predictors of postoperative recurrence (hazard ratio 6.012, P = 0.0035 and 6.760, P = 0.0049, respectively). Interestingly, a high NLR independently predicted postoperative liver, but not lymph node, metastasis.

Conclusions

In this patient series, a high NLR (≥2.4) was a noninvasive marker that independently predicted postoperative liver metastasis in patients with PNETs, and thereby could be clinically useful.

Keywords

Pancreatic neuroendocrine tumor WHO grade Neutrophil-to-lymphocyte ratio Postoperative metachronous liver metastasis 

Copyright information

© Japan Society of Clinical Oncology 2017

Authors and Affiliations

  • Kota Arima
    • 1
  • Hirohisa Okabe
    • 1
  • Daisuke Hashimoto
    • 1
  • Akira Chikamoto
    • 1
  • Hidetoshi Nitta
    • 1
  • Takaaki Higashi
    • 1
  • Takayoshi Kaida
    • 1
  • Kensuke Yamamura
    • 1
  • Yuki Kitano
    • 1
  • Yoshihiro Komohara
    • 2
  • Yo-ichi Yamashita
    • 1
  • Toru Beppu
    • 1
  • Motohiro Takeya
    • 2
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
  2. 2.Department of Cell Pathology, Graduate School of Medical SciencesKumamoto University HospitalKumamotoJapan