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Prognostic Factors in Resected Pancreatic Ductal Adenocarcinoma: Is Neutrophil-Lymphocyte Ratio a Useful Marker?

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Abstract

Background

The aim of this study is to analyze the role of neutrophil–lymphocyte ratio (NLR) and its variation pre- and postoperatively (delta NLR) in the overall survival after pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) at a single center and to identify factors associated with overall survival.

Methods

A retrospective study of consecutive patients undergoing pancreatectomy due to PDAC or undifferentiated carcinoma from January 2010 to January 2020 was performed. Association between the evaluated factors and overall survival was analyzed using a log-rank test and Cox proportional hazard regression model.

Results

Overall, 242 patients underwent pancreatectomy for PDAC or undifferentiated carcinoma. OS was 22.8 months (95% confidence interval (CI): 19.5–29), and survival rates at 1, 3, and 5 years were 72%, 32.5%, and 20.8%, respectively. NLR and delta NLR were not significantly associated with survival (hazard ratio (HR) = 1.14, 95%CI: 0.77–1.68, p = 0.5). Lymph node ratio was significantly associated (HR = 1.66, 95%CI: 1.21–2.26, p = 0.001) in the bivariate analysis. In multivariable analysis, the only factors that were significantly associated with survival were perineural invasion (HR = 1.94, 95%CI: 1.21–3.14, p = 0.006), surgical margin (HR = 1.83, 95%CI: 1.10–3.02, p = 0.019), tumor size (HR = 1.01, 95%CI: 1.003–1.027, p = 0.16), postoperative CA 19–9 level (HR = 1.001, p < 0.001), and completion of adjuvant treatment (HR = 0.53, 95%CI: 0.35–0.8, p = 0.002).

Conclusion

Neutrophil–lymphocyte ratio and delta NLR were not associated with the overall survival in this cohort. Risk factors such as perineural invasion, surgical margins, CA19-9 level, and tumor size showed worse survival in this study, whereas completing adjuvant treatment was a protective factor.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, Division of HPB Surgery. Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABB, Buenos Aires, Argentina

    Ignacio Merlo, Rodrigo Sanchez-Clariá, Eugenia Fratantoni & Oscar Mazza

  2. Department of General Surgery, Division of HPB Surgery and Liver Transplant Unit. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Victoria Ardiles, Eduardo de Santibañes, Juan Pekolj & Martín de Santibañes

Authors
  1. Ignacio Merlo
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  2. Victoria Ardiles
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  3. Rodrigo Sanchez-Clariá
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  4. Eugenia Fratantoni
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  5. Eduardo de Santibañes
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  6. Juan Pekolj
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  8. Martín de Santibañes
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Contributions

(I) Conception and design: Martín de Santibañes, Ignacio G. Merlo. (II) Administrative support: Juan Pekolj. (III) Provision of study materials or patients: Oscar Mazza, Rodrigo Sanchez Claria, Juan Pekolj, Martín de Santibañes, Eduardo de Santibañes. (IV) Collection and assembly of data: Ignacio G. Merlo, Eugenia Fratantoni. (V) Data analysis and interpretation: Ignacio G. Merlo, Victoria Ardiles. (VI) Manuscript writing: All authors. (VII) Final approval of manuscript: All authors.

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Correspondence to Ignacio Merlo.

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Merlo, I., Ardiles, V., Sanchez-Clariá, R. et al. Prognostic Factors in Resected Pancreatic Ductal Adenocarcinoma: Is Neutrophil-Lymphocyte Ratio a Useful Marker?. J Gastrointest Canc 54, 580–588 (2023). https://doi.org/10.1007/s12029-022-00839-7

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