The lymphocyte to monocyte ratio in peripheral blood represents a novel prognostic marker in patients with pancreatic cancer.
BACKGROUND
Intra-tumoral macrophages have been involved as important players in the pathogenesis and progression of cancer. Recently, inflammatory parameters of the systemic inflammatory response have also been proposed as usefully prognostic biomarkers. One of these, the lymphocyte to monocyte ratio (LMR) in peripheral blood has been shown as a prognostic factor in hematologic and some solid tumors. In this study we analyzed for the first time the prognostic value of LMR in a large middle European cohort of pancreatic cancer (PC) patients.


METHODS
Data from 474 consecutive patients with ductal adenocarcinoma of the pancreas were evaluated retrospectively. Cancer-specific survival (CSS) was analyzed using the Kaplan-Meier method. To further evaluate the prognostic significance of the LMR, univariate and multivariate Cox regression models were calculated.


RESULTS
Increased LMR at diagnosis was significantly associated with well-established prognostic factors, including high tumor stage and tumor grade (p<0.05). In univariate analysis, we observed that an increased LMR was a significant factor for better CSS in PC patients (HR 0.70; 95% CI 0.57-0.85; p<0.001). In multivariate analysis including age, Karnofsky Index, tumor grade, tumor stage, administration of chemotherapy, LMR and surgical resection, we confirmed increased LMR as an independent prognostic factor for CSS (HR 0.81; 95% CI 0.66-0.99; p=0.04).


CONCLUSIONS
In conclusion, we identified LMR as an independent prognostic factor in PC patients. Our results indicate that the LMR might represent a novel and useful marker for patient stratification in PC management.
Michael
M
Stotz
Joanna
J
Szkandera
Tatjana
T
Stojakovic
Julia
J
Seidel
Hellmut
H
Samonigg
Peter
P
Kornprat
Renate
R
Schaberl-Moser
Fridericke
F
Seggewies
Gerald
G
Hoefler
Armin
A
Gerger
Martin
M
Pichler
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D009000:Monocytes; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D011379:Prognosis; D012189:Retrospective Studies
D014408:Biomarkers, Tumor