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

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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.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Kota Arima, Hirohisa Okabe, Daisuke Hashimoto, Akira Chikamoto, Hidetoshi Nitta, Takaaki Higashi, Takayoshi Kaida, Kensuke Yamamura, Yuki Kitano, Yo-ichi Yamashita, Toru Beppu & Hideo Baba

  2. Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University Hospital, Kumamoto, Japan

    Yoshihiro Komohara & Motohiro Takeya

Authors
  1. Kota Arima
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  2. Hirohisa Okabe
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  3. Daisuke Hashimoto
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  13. Motohiro Takeya
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  14. Hideo Baba
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Corresponding author

Correspondence to Hideo Baba.

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The authors have no conflicts of interest to report and no proprietary or commercial interest in any product mentioned or the concept discussed in this article.

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Arima, K., Okabe, H., Hashimoto, D. et al. Neutrophil-to-lymphocyte ratio predicts metachronous liver metastasis of pancreatic neuroendocrine tumors. Int J Clin Oncol 22, 734–739 (2017). https://doi.org/10.1007/s10147-017-1111-4

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  • DOI: https://doi.org/10.1007/s10147-017-1111-4

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