The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Resected Patients with Pancreatic Adenocarcinoma
Purpose This research aims to analyze neutrophil-to-lymphocyte ratio (NLR) for resectable pancreatic ductal adenocarcinoma (PDAC) patients and reveal its predictive value. Methods We enrolled 389 pancreatic adenocarcinoma patients who had undergone curative surgery between January 1, 2008 and August...
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| Veröffentlicht in: | World journal of surgery 2018-11, Vol.42 (11), p.3736-3745 |
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| creator | Fang, Le-ping Xu, Xiao-yan Ji, Yu Huang, Pu-wen |
| description | Purpose
This research aims to analyze neutrophil-to-lymphocyte ratio (NLR) for resectable pancreatic ductal adenocarcinoma (PDAC) patients and reveal its predictive value.
Methods
We enrolled 389 pancreatic adenocarcinoma patients who had undergone curative surgery between January 1, 2008 and August 15, 2015 in Jiangsu Provincial People’s Hospital, and they were followed up until December 20, 2016. Among them, 219 patients had definite recurrence record in our hospital. The appropriate cutoff value for the NLR was obtained from X-tile software. The association between qualitative variables and NLR was analyzed by Chi-square test or Fisher’s exact test, and for quantitative values, the association was analyzed by independent Student’s
t
test. Additionally, survival analysis was performed by Kaplan–Meier plots. Independent prognostic factors were found according to Cox regression analysis.
Results
Based on univariate analysis, the elevated preoperative NLR had an important influence on the decreased recurrence-free survival (RFS) (8.2 vs. 14.9 months) and overall survival (OS) (13.7 vs. 22 months), and this result also counted in the multivariate analysis. Regarding OS, both patients with or without postoperative chemotherapy can obtain benefits from low NLR according to subgroup analysis. Stage I and II pancreatic adenocarcinoma patients can get longer OS and RFS from low NLR, while patients with stage III cancer cannot. Regarding recurrence site, high NLR level was also related to distant metastasis (
P
= 0.02).
Conclusion
Preoperative NLR level could be a useful prognostic indication for resectable pancreatic adenocarcinoma patients. |
| doi_str_mv | 10.1007/s00268-018-4686-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2071570345</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2070616847</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4220-405a14a29027e9e5629f33b0507ea65c966b33f8ed1ebb420b72440df13d64d3</originalsourceid><addsrcrecordid>eNqFkU9v1DAQxS0EotvCB-CCLHHhEhj_iZMcS0UpaAVVWcHRcpxJ11USp3bCar89jlJAQkKcPJ75vacnPUJeMHjDAIq3EYCrMgNWZlKVKisekQ2TgmdccPGYbEAomWYmTshpjHcArFCgnpITkUbJK74hh90e6XXwt4OPk7P0m-lmpL5NO_QjBjO5H0g_4zwFP-5dl00-2x77ce_tcUJ6k-6euoHeYEQ7YUOv0waHKdKDm_bpN9iAZnE-b3Dw1gTrBt-bZ-RJa7qIzx_eM7K7fL-7uMq2Xz58vDjfZlZyDpmE3DBpeAW8wApzxatWiBpyKNCo3FZK1UK0JTYM61pyqAsuJTQtE42SjTgjr1fbMfj7GeOkexctdp0Z0M9RcyhYXoCQeUJf_YXe-TkMKdxCgWKqlEWi2ErZ4GMM2OoxuN6Eo2agl1L0WopOpeilFL1oXj44z3WPzW_FrxYSUK3AwXV4_L-j_v7p67tLqFKspOWrNibZcIvhT-x_J_oJBEyoQg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2070616847</pqid></control><display><type>article</type><title>The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Resected Patients with Pancreatic Adenocarcinoma</title><source>MEDLINE</source><source>Wiley Journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Fang, Le-ping ; Xu, Xiao-yan ; Ji, Yu ; Huang, Pu-wen</creator><creatorcontrib>Fang, Le-ping ; Xu, Xiao-yan ; Ji, Yu ; Huang, Pu-wen</creatorcontrib><description>Purpose
This research aims to analyze neutrophil-to-lymphocyte ratio (NLR) for resectable pancreatic ductal adenocarcinoma (PDAC) patients and reveal its predictive value.
Methods
We enrolled 389 pancreatic adenocarcinoma patients who had undergone curative surgery between January 1, 2008 and August 15, 2015 in Jiangsu Provincial People’s Hospital, and they were followed up until December 20, 2016. Among them, 219 patients had definite recurrence record in our hospital. The appropriate cutoff value for the NLR was obtained from X-tile software. The association between qualitative variables and NLR was analyzed by Chi-square test or Fisher’s exact test, and for quantitative values, the association was analyzed by independent Student’s
t
test. Additionally, survival analysis was performed by Kaplan–Meier plots. Independent prognostic factors were found according to Cox regression analysis.
Results
Based on univariate analysis, the elevated preoperative NLR had an important influence on the decreased recurrence-free survival (RFS) (8.2 vs. 14.9 months) and overall survival (OS) (13.7 vs. 22 months), and this result also counted in the multivariate analysis. Regarding OS, both patients with or without postoperative chemotherapy can obtain benefits from low NLR according to subgroup analysis. Stage I and II pancreatic adenocarcinoma patients can get longer OS and RFS from low NLR, while patients with stage III cancer cannot. Regarding recurrence site, high NLR level was also related to distant metastasis (
P
= 0.02).
Conclusion
Preoperative NLR level could be a useful prognostic indication for resectable pancreatic adenocarcinoma patients.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-018-4686-7</identifier><identifier>PMID: 30014292</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adenocarcinoma ; Adult ; Aged ; Carcinoma, Pancreatic Ductal - blood ; Carcinoma, Pancreatic Ductal - mortality ; Carcinoma, Pancreatic Ductal - pathology ; Carcinoma, Pancreatic Ductal - surgery ; Cardiac Surgery ; Chemotherapy ; Female ; General Surgery ; Humans ; Lymphocytes ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Metastases ; Middle Aged ; Multivariate analysis ; Neoplasm Staging ; Neutrophils ; Original Scientific Report ; Pancreas ; Pancreatic cancer ; Pancreatic Neoplasms - blood ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - surgery ; Patients ; Preoperative Period ; Prognosis ; Qualitative analysis ; Regression analysis ; Retrospective Studies ; Statistical tests ; Subgroups ; Surgery ; Survival ; Survival analysis ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2018-11, Vol.42 (11), p.3736-3745</ispartof><rights>Société Internationale de Chirurgie 2018</rights><rights>2018 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4220-405a14a29027e9e5629f33b0507ea65c966b33f8ed1ebb420b72440df13d64d3</citedby><cites>FETCH-LOGICAL-c4220-405a14a29027e9e5629f33b0507ea65c966b33f8ed1ebb420b72440df13d64d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-018-4686-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-018-4686-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,41488,42557,45574,45575,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30014292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fang, Le-ping</creatorcontrib><creatorcontrib>Xu, Xiao-yan</creatorcontrib><creatorcontrib>Ji, Yu</creatorcontrib><creatorcontrib>Huang, Pu-wen</creatorcontrib><title>The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Resected Patients with Pancreatic Adenocarcinoma</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Purpose
This research aims to analyze neutrophil-to-lymphocyte ratio (NLR) for resectable pancreatic ductal adenocarcinoma (PDAC) patients and reveal its predictive value.
Methods
We enrolled 389 pancreatic adenocarcinoma patients who had undergone curative surgery between January 1, 2008 and August 15, 2015 in Jiangsu Provincial People’s Hospital, and they were followed up until December 20, 2016. Among them, 219 patients had definite recurrence record in our hospital. The appropriate cutoff value for the NLR was obtained from X-tile software. The association between qualitative variables and NLR was analyzed by Chi-square test or Fisher’s exact test, and for quantitative values, the association was analyzed by independent Student’s
t
test. Additionally, survival analysis was performed by Kaplan–Meier plots. Independent prognostic factors were found according to Cox regression analysis.
Results
Based on univariate analysis, the elevated preoperative NLR had an important influence on the decreased recurrence-free survival (RFS) (8.2 vs. 14.9 months) and overall survival (OS) (13.7 vs. 22 months), and this result also counted in the multivariate analysis. Regarding OS, both patients with or without postoperative chemotherapy can obtain benefits from low NLR according to subgroup analysis. Stage I and II pancreatic adenocarcinoma patients can get longer OS and RFS from low NLR, while patients with stage III cancer cannot. Regarding recurrence site, high NLR level was also related to distant metastasis (
P
= 0.02).
Conclusion
Preoperative NLR level could be a useful prognostic indication for resectable pancreatic adenocarcinoma patients.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma</subject><subject>Adult</subject><subject>Aged</subject><subject>Carcinoma, Pancreatic Ductal - blood</subject><subject>Carcinoma, Pancreatic Ductal - mortality</subject><subject>Carcinoma, Pancreatic Ductal - pathology</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Cardiac Surgery</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Staging</subject><subject>Neutrophils</subject><subject>Original Scientific Report</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - blood</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Patients</subject><subject>Preoperative Period</subject><subject>Prognosis</subject><subject>Qualitative analysis</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Statistical tests</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU9v1DAQxS0EotvCB-CCLHHhEhj_iZMcS0UpaAVVWcHRcpxJ11USp3bCar89jlJAQkKcPJ75vacnPUJeMHjDAIq3EYCrMgNWZlKVKisekQ2TgmdccPGYbEAomWYmTshpjHcArFCgnpITkUbJK74hh90e6XXwt4OPk7P0m-lmpL5NO_QjBjO5H0g_4zwFP-5dl00-2x77ce_tcUJ6k-6euoHeYEQ7YUOv0waHKdKDm_bpN9iAZnE-b3Dw1gTrBt-bZ-RJa7qIzx_eM7K7fL-7uMq2Xz58vDjfZlZyDpmE3DBpeAW8wApzxatWiBpyKNCo3FZK1UK0JTYM61pyqAsuJTQtE42SjTgjr1fbMfj7GeOkexctdp0Z0M9RcyhYXoCQeUJf_YXe-TkMKdxCgWKqlEWi2ErZ4GMM2OoxuN6Eo2agl1L0WopOpeilFL1oXj44z3WPzW_FrxYSUK3AwXV4_L-j_v7p67tLqFKspOWrNibZcIvhT-x_J_oJBEyoQg</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Fang, Le-ping</creator><creator>Xu, Xiao-yan</creator><creator>Ji, Yu</creator><creator>Huang, Pu-wen</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201811</creationdate><title>The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Resected Patients with Pancreatic Adenocarcinoma</title><author>Fang, Le-ping ; Xu, Xiao-yan ; Ji, Yu ; Huang, Pu-wen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4220-405a14a29027e9e5629f33b0507ea65c966b33f8ed1ebb420b72440df13d64d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma</topic><topic>Adult</topic><topic>Aged</topic><topic>Carcinoma, Pancreatic Ductal - blood</topic><topic>Carcinoma, Pancreatic Ductal - mortality</topic><topic>Carcinoma, Pancreatic Ductal - pathology</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Cardiac Surgery</topic><topic>Chemotherapy</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neoplasm Staging</topic><topic>Neutrophils</topic><topic>Original Scientific Report</topic><topic>Pancreas</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - blood</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Patients</topic><topic>Preoperative Period</topic><topic>Prognosis</topic><topic>Qualitative analysis</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Statistical tests</topic><topic>Subgroups</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fang, Le-ping</creatorcontrib><creatorcontrib>Xu, Xiao-yan</creatorcontrib><creatorcontrib>Ji, Yu</creatorcontrib><creatorcontrib>Huang, Pu-wen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fang, Le-ping</au><au>Xu, Xiao-yan</au><au>Ji, Yu</au><au>Huang, Pu-wen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Resected Patients with Pancreatic Adenocarcinoma</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2018-11</date><risdate>2018</risdate><volume>42</volume><issue>11</issue><spage>3736</spage><epage>3745</epage><pages>3736-3745</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Purpose
This research aims to analyze neutrophil-to-lymphocyte ratio (NLR) for resectable pancreatic ductal adenocarcinoma (PDAC) patients and reveal its predictive value.
Methods
We enrolled 389 pancreatic adenocarcinoma patients who had undergone curative surgery between January 1, 2008 and August 15, 2015 in Jiangsu Provincial People’s Hospital, and they were followed up until December 20, 2016. Among them, 219 patients had definite recurrence record in our hospital. The appropriate cutoff value for the NLR was obtained from X-tile software. The association between qualitative variables and NLR was analyzed by Chi-square test or Fisher’s exact test, and for quantitative values, the association was analyzed by independent Student’s
t
test. Additionally, survival analysis was performed by Kaplan–Meier plots. Independent prognostic factors were found according to Cox regression analysis.
Results
Based on univariate analysis, the elevated preoperative NLR had an important influence on the decreased recurrence-free survival (RFS) (8.2 vs. 14.9 months) and overall survival (OS) (13.7 vs. 22 months), and this result also counted in the multivariate analysis. Regarding OS, both patients with or without postoperative chemotherapy can obtain benefits from low NLR according to subgroup analysis. Stage I and II pancreatic adenocarcinoma patients can get longer OS and RFS from low NLR, while patients with stage III cancer cannot. Regarding recurrence site, high NLR level was also related to distant metastasis (
P
= 0.02).
Conclusion
Preoperative NLR level could be a useful prognostic indication for resectable pancreatic adenocarcinoma patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30014292</pmid><doi>10.1007/s00268-018-4686-7</doi><tpages>10</tpages></addata></record> |
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| subjects | Abdominal Surgery Adenocarcinoma Adult Aged Carcinoma, Pancreatic Ductal - blood Carcinoma, Pancreatic Ductal - mortality Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - surgery Cardiac Surgery Chemotherapy Female General Surgery Humans Lymphocytes Male Medical prognosis Medicine Medicine & Public Health Metastases Middle Aged Multivariate analysis Neoplasm Staging Neutrophils Original Scientific Report Pancreas Pancreatic cancer Pancreatic Neoplasms - blood Pancreatic Neoplasms - mortality Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Patients Preoperative Period Prognosis Qualitative analysis Regression analysis Retrospective Studies Statistical tests Subgroups Surgery Survival Survival analysis Thoracic Surgery Vascular Surgery |
| title | The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Resected Patients with Pancreatic Adenocarcinoma |
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