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Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil-lymphocyte and platelet-lymphocyte ratios

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Abstract

Purpose

The therapeutic strategy for borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) has remained unestablished because the preoperative prognostic factors have not been determined.

Methods

One hundred eighty-four consecutive PDAC patients who underwent upfront surgery with a curative resection between January 2000 and June 2013 at Kobe University Hospital were retrospectively studied. The PDAC patients were stratified into resectable (R)-PDAC (n = 147) and BR-PDAC patients (n = 37). We evaluated the independent prognostic significance of the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) in the BR-PDAC patients.

Results

BR-PDAC patient survival was significantly worse than R-PDAC patient survival (median survival time: 22.1 months vs. 24.3 months; 5-year survival rate 6 vs. 21 %; P = 0.042). The median survival in BR-PDAC patients with a preoperative NLR of >3 (n = 12) was 10.2 months, while that in patients with preoperative NLR of ≤3 (n = 25) was 24.9 months (P = 0.002). Moreover, the median survival in BR-PDAC patients with a preoperative PLR of >225 (n = 8) was 10.2 months, while that in patients with a preoperative PLR of ≤225 (n = 29) was 24.7 months (P = 0.003). Preoperative NLR >3 (HR = 2.980, 95 % CI 1.251–6.920; P = 0.015) and PLR >225 (HR = 3.050, 95 % CI 1.169–7.468; P = 0.024) were independent prognostic factors in BR-PDAC patients.

Conclusions

Higher preoperative NLR and PLR can be independent predictive risk factors in BR-PDAC patients following curative resection.

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Acknowledgments

We are grateful to the Department of Pathology at Kobe University Hospital for their pathological diagnoses of pancreatic adenocarcinoma. We also thank St. Luke’s Life Science Institute, Center for Clinical Epidemiology for the stimulating discussion regarding statistical analyses.

Conflict of interest

The authors declare no conflicts of interest in association with the present study.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Sadaki Asari, Ippei Matsumoto, Hirochika Toyama, Makoto Shinzeki, Tadahiro Goto, Jun Ishida, Tetsuo Ajiki, Takumi Fukumoto & Yonson Ku

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  1. Sadaki Asari
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  2. Ippei Matsumoto
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Correspondence to Sadaki Asari.

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Asari, S., Matsumoto, I., Toyama, H. et al. Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil-lymphocyte and platelet-lymphocyte ratios. Surg Today 46, 583–592 (2016). https://doi.org/10.1007/s00595-015-1206-3

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