title: Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma.
abstract: BACKGROUND
  The objective of this study was to investigate whether the preoperative platelet-lymphocyte (P/L) ratio represents a significant prognostic index in resected pancreatic ductal adenocarcinoma.
  
  
  METHODS
  A total of 110 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a prospectively maintained database.
  
  
  RESULTS
  The preoperative P/L ratio was found to be a more significant prognostic marker (P < .001) than either the lymphocyte count (P = .007) or platelet count (P = .068) on univariate Cox survival analysis. The median overall survival in patients with a P/L ratio of 150 or less (n = 48) was 19.7 months, 13.7 months in those with a P/L ratio of 151 to 300 (n = 43), and 5.8 months in patients with a value of greater than 300 (n = 19) (log-rank, P = .006). The preoperative P/L ratio retained significance on multivariate analysis (P < .001), along with tumor size (P = .010) and lymph node ratio (P = .013).
  
  
  CONCLUSIONS
  The preoperative P/L ratio represents a significant independent prognostic index in patients of resected pancreatic adenocarcinoma.
authors.affiliation: Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, Liverpool, UK. rsmith3@liverpool.ac.uk
authors.forename: Richard A
authors.initials: RA
authors.lastname: Smith
authors.forename: Lorraine
authors.initials: L
authors.lastname: Bosonnet
authors.forename: Michael
authors.initials: M
authors.lastname: Raraty
authors.forename: Robert
authors.initials: R
authors.lastname: Sutton
authors.forename: John P
authors.initials: JP
authors.lastname: Neoptolemos
authors.forename: Fiona
authors.initials: F
authors.lastname: Campbell
authors.forename: Paula
authors.initials: P
authors.lastname: Ghaneh
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000601:surgery*; D010976:Platelet Count; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis
chemical_list: D015415:Biomarkers