title: Neutrophil-to-lymphocyte ratio for predicting palliative chemotherapy outcomes in advanced pancreatic cancer patients.
abstract: Several previous studies reported that the neutrophil-to-lymphocyte ratio (NLR) could be a promising prognostic factor for patients with cancer. We aimed to determine the prognostic value of NLR in patients with advanced pancreatic cancer (APC) following palliative chemotherapy. We retrospectively reviewed 252 consecutive APC patients receiving palliative chemotherapy between January 2006 and December 2012. We classified the patients according to the pretreatment NLR values (≤ 5 or >5) into two groups and investigated the difference in treatment outcomes, including time to treatment failure (TTF) and overall survival (OS). A total of 212 patients had pretreatment NLR values of ≤ 5 (group A), while 40 patients had an NLR of >5 (group B). TTF and OS were significantly shorter in group B than in group A (3.1 vs. 8.7 months and 6.0 vs. 12.8 months, respectively; both P < 0.01). After adjustment for putative prognostic factors, including distant metastasis, status of recurrent/unresectable disease, pretreatment carbohydrate antigen 19-9 levels, and carcinoembryonic antigen levels using the Cox regression model, elevated pretreatment NLR remained an independent poor prognostic factor for OS (hazard ratio, 1.92; 95% confidence interval, 1.27-2.90; P < 0.01). In addition, patients in group B whose NLR dropped to ≤ 5 before the second cycle of chemotherapy showed longer TTF and OS compared with those whose NLR remained at >5. Our results support the idea that NLR can be a promising prognostic and predictive marker for APC patients receiving palliative chemotherapy.
authors: Department of Clinical Oncology and Pharmacogenomics, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Medical Oncology and Shanghai Key Laboratory for Pancreatic Diseases, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, China.
authors: Peng
authors: P
authors: Xue
authors: Masashi
authors: M
authors: Kanai
authors: Yukiko
authors: Y
authors: Mori
authors: Takafumi
authors: T
authors: Nishimura
authors: Norimitsu
authors: N
authors: Uza
authors: Yuzo
authors: Y
authors: Kodama
authors: Yoshiya
authors: Y
authors: Kawaguchi
authors: Kyoichi
authors: K
authors: Takaori
authors: Shigemi
authors: S
authors: Matsumoto
authors: Shinji
authors: S
authors: Uemoto
authors: Tsutomu
authors: T
authors: Chiba
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000188:drug therapy*; D015331:Cohort Studies; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D004338:Drug Combinations; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D009504:Neutrophils / Q000473:pathology*; D010094:Oxonic Acid / Q000008:administration & dosage; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D011799:Quinazolines / Q000008:administration & dosage; D016019:Survival Analysis; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D011799:Quinazolines; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000069347:Erlotinib Hydrochloride; D000093542:Gemcitabine
keywords: Chemotherapy; NLR; inflammation; pancreatic cancer; prognostic factor