title: Clinical Implication of Inflammation-Based Prognostic Score in Pancreatic Cancer: Glasgow Prognostic Score Is the Most Reliable Parameter.
abstract: A variety of systemic inflammation-based prognostic scores have been explored; however, there has been no study to clarify which score could best reflect survival in resected pancreatic cancer patients.Between 2002 and 2014, 379 consecutive patients who underwent curative resection of pancreatic cancer were enrolled. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), prognostic index (PI), and prognostic nutritional index (PNI) scores for each patient were calculated. Survival of each score was evaluated, and correlations between the score selected on the basis of the prognostic significance and various clinicopathological factors were analyzed.In the analysis of the GPS, the median survival time (MST) was 28.1 months for score 0, 25.6 for score 1, and 17.0 for score 2. As for mGPS, the MST was 25.8 months for score 0, 27.7 for score 1, and 17.0 for score 2. Both scores were found to be significant. On the contrary, there were no statistical differences in MST between various scores obtained using the NLR, PLR, PI, or PNI. Multivariate analysis revealed that lymph node metastasis, positive peritoneal washing cytology, and a GPS score of 2 were significant prognostic factors. There was also statistically significant correlation between the GPS score and tumor location (head), tumor size (≥2.0 cm), bile duct invasion, and duodenal invasion.Our study demonstrated that the GPS could be an independent predictive marker and was superior to other inflammation-based prognostic scores in patients with resected pancreatic cancer.
authors.affiliation: From the Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine (SY, TF, NY, NI, MK, CT, GN, HS, MK, MF, YK), and Center for Advanced Medicine and Clinical Research (KM), Nagoya University Hospital, Aichi, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Yamada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Fujii
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Yabusaki
authors.forename: Kenta
authors.initials: K
authors.lastname: Murotani
authors.forename: Naoki
authors.initials: N
authors.lastname: Iwata
authors.forename: Mitsuro
authors.initials: M
authors.lastname: Kanda
authors.forename: Chie
authors.initials: C
authors.lastname: Tanaka
authors.forename: Goro
authors.initials: G
authors.lastname: Nakayama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koike
authors.forename: Michitaka
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000556:secondary / Q000601:surgery*; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D008207:Lymphatic Metastasis; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010976:Platelet Count; D011379:Prognosis; D012709:Serum Albumin / Q000378:metabolism*; D015996:Survival Rate
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein