title: Neutrophil-lymphocyte and platelet-lymphocyte ratio in patients after resection for hepato-pancreatico-biliary malignancies.
abstract: OBJECTIVE
  We sought to determine whether Neutrophil-lymphocyte ratio (NLR) or platelet-lymphocyte ratio (PLR) were associated with outcomes of patients undergoing surgery for a hepatopancreatico-biliary (HPB) malignancy.
  
  
  METHODS
  Between 2000 and 2013, 452 patients who underwent an HPB procedure for a malignant indication were identified. Clinicopathological characteristics, NLR, and PLR, as well as short- and long-term outcomes were analyzed. High NLR and PLR were classified using a cut-off value of 5 and 190, respectively, based on ROC curve analysis.
  
  
  RESULTS
  Patients with low versus high NLR and PLR had similar baseline characteristics with regard to performance status and tumor stage (all P > 0.05). Elevated PLR (HR = 1.40) tends to be association with shorter recurrence-free survival (RFS) (P = 0.05), whereas NLR was not a predictor of shorter RFS. Differently, both elevated NLR (HR = 1.94) and PLR (HR = 1.79) were associated with worse overall survival (OS) (both P < 0.05). Patients with NLR ≥5 and those with PLR ≥190 had a significantly shorter OS compared to patients with NLR <5 and PLR <190, respectively (log-rank test, both P < 0.05). Moreover, patients who had both NLR and PLR elevated had worse OS compared to patients with either one or none inflammatory markers elevated (log-rank P = 0.02).
  
  
  CONCLUSIONS
  Elevated NLR and PLR were predictors of worse long-term outcome among patients with HPB malignancy undergoing resection.
authors: The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: G
authors: G
authors: Spolverato
authors: H
authors: H
authors: Maqsood
authors: Y
authors: Y
authors: Kim
authors: Ga
authors: G
authors: Margonis
authors: T
authors: T
authors: Luo
authors: A
authors: A
authors: Ejaz
authors: T M
authors: TM
authors: Pawlik
mesh_terms: D000368:Aged; D001661:Biliary Tract Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D001792:Blood Platelets / Q000473:pathology*; D013505:Digestive System Surgical Procedures / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate
keywords: hepatopancreatico-biliary surgery; neutrophil-lymphocyte ratio; outcome; platelets-lymphocyte ratio