title: Prognostic value of systemic inflammation-based markers in advanced pancreatic cancer.
abstract: BACKGROUND
  The prognostic significance of various systemic inflammation-based markers has been explored in different cancers. These markers can be used to assist with decision-making in oncology clinics.
  
  
  OBJECTIVE
  The aim of this study was to investigate the prognostic significance of three systemic inflammation-based factors: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and modified Glasgow Prognostic Score (mGPS) in patients with advanced pancreatic cancer.
  
  
  METHODS
  Data were collected retrospectively for advanced pancreatic cancer patients treated between 1 January 2008 and 31 December 2012 at the Royal Perth Hospital. The ratios were dichotomised as <5 versus ≥5 for NLR and <200 versus ≥200 for PLR. Modified Glasgow Prognostic Scores were scored as: mGPS '0' = both C-reactive protein (CRP) and albumin normal, mGPS '1' = elevated CRP < 10 mg/L and mGPS '2' = both elevated CRP > 10 mg/L and albumin < 35 g/L. Univariate and multivariate analyses were carried out.
  
  
  RESULTS
  Data were evaluable for 124 patients. Median survivals based on the three inflammation-based prognostic markers evaluated were: NLR <5 versus ≥5 = 8.5 months versus 2.6 months respectively (P = 0.0007; hazard ratio (HR) 1.81), PLR <200 versus ≥200 = 9.1 months versus 4 months respectively (P = 0.007; HR 1.64) and mGPS score 1, 2, 3 = 8.3 months, 9.6 months and 1.8 months respectively (P = 0.0004). Besides Eastern Cooperative Oncology Group performance status, NLR, PLR and mGPS were significant independent prognostic markers both on univariate as well as multivariate analysis.
  
  
  CONCLUSIONS
  Our findings suggest that the NLR, PLR and mGPS derived from routine blood tests can be used as clinically meaningful biomarkers to stratify advanced pancreatic cancer patients into different prognostic groups.
authors.affiliation: Department of Medical Oncology, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: H L
authors.initials: HL
authors.lastname: Martin
authors.forename: K
authors.initials: K
authors.lastname: Ohara
authors.forename: A
authors.initials: A
authors.lastname: Kiberu
authors.forename: T
authors.initials: T
authors.lastname: Van Hagen
authors.forename: A
authors.initials: A
authors.lastname: Davidson
authors.forename: M A
authors.initials: MA
authors.lastname: Khattak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators
keywords: biomarker; cancer; chemotherapy; inflammation; pancreas; prognosis