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Blood Neutrophil–Lymphocyte Ratio Predicts Survival in Patients with Advanced Pancreatic Cancer Treated with Chemotherapy

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although a high neutrophil-to-lymphocyte ratio (NLR) has been reported to be a predictor of poor survival in patients with pancreatic cancers, its prognostic role in patients with advanced pancreatic cancer undergoing chemotherapy remains unclear. This study was performed to determine the prognostic role of NLR in patients with advanced pancreatic cancer undergoing chemotherapy.

Methods

We retrospectively enrolled 403 patients undergoing chemotherapy for advanced pancreatic adenocarcinoma from 2002 to 2013. Univariate and multivariate analyses were performed to identify clinicopathological predictors of overall survival including baseline NLR (NLR before chemotherapy) and postchemotherapy NLR change (NLR change before and after one cycle of chemotherapy), using the Cox proportional hazards model. Clinicopathological characteristics related to baseline NLR and postchemotherapy NLR change were evaluated.

Results

Univariate and multivariate analyses showed that both baseline NLR (NLR ≥ 3.1 vs. NLR < 3.1, hazard ratio [HR] = 1.42; P = 0.001) and postchemotherapy NLR change (NLR ≥ 3.1 and increased vs. NLR < 3.1 and decreased, HR = 2.39; P = 0.000) were independent prognostic factors in overall survival. NLR ≥ 3.1 before chemotherapy and NLR postchemotherapy change were significantly correlated with distant metastasis, serum CA19-9 levels, and serum albumin levels.

Conclusions

Baseline NLR and postchemotherapy NLR change may serve as potential biomarkers for overall survival in patients with advanced pancreatic cancer undergoing chemotherapy.

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Acknowledgment

This study was supported in part by the Sino-German Center (GZ857), by the Science Foundation of Shanghai (13ZR1407500), by the Shanghai Rising Star Program (12QH1400600, 14QA1400900), by the Fudan University Young Investigator-promoting program (20520133403), and by the National Science Foundation of China (Grant No. 81101807, No. 81001058, No. 81372649, No. 81372653, and No. 81172276).

Disclosure

The authors declare no potential conflicts of interest in this study.

Author information

Authors and Affiliations

  1. Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, Peoples Republic of China

    Guopei Luo MD, PhD, Meng Guo PhD, Zuqiang Liu MD, Zhiwen Xiao MD, Kaizhou Jin MD, PhD, Jiang Long MD, PhD, Liang Liu MD, PhD, Chen Liu MD, PhD, Jin Xu MD, PhD, Quanxing Ni MD & Xianjun Yu MD, PhD

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Peoples Republic of China

    Guopei Luo MD, PhD, Meng Guo PhD, Zuqiang Liu MD, Zhiwen Xiao MD, Kaizhou Jin MD, PhD, Jiang Long MD, PhD, Liang Liu MD, PhD, Chen Liu MD, PhD, Jin Xu MD, PhD, Quanxing Ni MD & Xianjun Yu MD, PhD

  3. Pancreatic Cancer Institute, Fudan University, Shanghai, Peoples Republic of China

    Guopei Luo MD, PhD, Meng Guo PhD, Zuqiang Liu MD, Zhiwen Xiao MD, Kaizhou Jin MD, PhD, Jiang Long MD, PhD, Liang Liu MD, PhD, Chen Liu MD, PhD, Jin Xu MD, PhD, Quanxing Ni MD & Xianjun Yu MD, PhD

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  1. Guopei Luo MD, PhD
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  2. Meng Guo PhD
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  3. Zuqiang Liu MD
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  4. Zhiwen Xiao MD
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  5. Kaizhou Jin MD, PhD
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  6. Jiang Long MD, PhD
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  7. Liang Liu MD, PhD
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  8. Chen Liu MD, PhD
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  9. Jin Xu MD, PhD
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  10. Quanxing Ni MD
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  11. Xianjun Yu MD, PhD
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Corresponding author

Correspondence to Xianjun Yu MD, PhD.

Additional information

Guopei Luo, Meng Guo and Zuqiang Liu have contributed equally to the manuscript.

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Luo, G., Guo, M., Liu, Z. et al. Blood Neutrophil–Lymphocyte Ratio Predicts Survival in Patients with Advanced Pancreatic Cancer Treated with Chemotherapy. Ann Surg Oncol 22, 670–676 (2015). https://doi.org/10.1245/s10434-014-4021-y

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  • DOI: https://doi.org/10.1245/s10434-014-4021-y

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