title: The Neutrophil/Lymphocyte Ratio at Diagnosis Is Significantly Associated with Survival in Metastatic Pancreatic Cancer Patients.
abstract: Different inflammation-based scores such as the neutrophil/lymphocyte ratio (NLR), the Odonera Prognostic Nutritional Index (PNI), the Glasgow Prognostic Score, the platelet/lymphocyte ratio, and the C-reactive protein/albumin ratio have been found to be significantly associated with pancreatic cancer (PDAC) prognosis. However, most studies have investigated patients undergoing surgery, and few of them have compared these scores. We aimed at evaluating the association between inflammatory-based scores and PDAC prognosis. In a single center cohort study, inflammatory-based scores were assessed at diagnosis and their prognostic relevance as well as that of clinic-pathological variables were evaluated through multiple logistic regression and survival probability analysis. In 206 patients, age, male sex, tumor size, presence of distant metastasis, access to chemotherapy, and an NLR > 5 but not other scores were associated with overall survival (OS) at multivariate analysis. Patients with an NLR < 5 had a median survival of 12 months compared to 4 months in those with an NLR > 5. In the 81 patients with distant metastasis at diagnosis, an NLR > 5 resulted in the only variable significantly associated with survival. Among patients with metastatic disease who received chemotherapy, the median survival was 3 months in patients with an NLR > 5 and 7 months in those with an NLR < 5. The NLR might drive therapeutic options in PDAC patients, especially in the setting of metastatic disease.
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. matteopiciucchi@libero.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Piciucchi
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. seri_stigliano@yahoo.it.
authors.forename: Serena
authors.initials: S
authors.lastname: Stigliano
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. livia.archibugi@hotmail.it.
authors.forename: Livia
authors.initials: L
authors.lastname: Archibugi
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. giulia.zerboni@gmail.com.
authors.forename: Giulia
authors.initials: G
authors.lastname: Zerboni
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. mariannasignoretti@gmail.com.
authors.forename: Marianna
authors.initials: M
authors.lastname: Signoretti
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. viola.barucca@gmail.com.
authors.forename: Viola
authors.initials: V
authors.lastname: Barucca
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. robbie.valente@gmail.com.
authors.forename: Roberto
authors.initials: R
authors.lastname: Valente
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. gianfranco.dellefave@gmail.com.
authors.forename: Gianfranco Delle
authors.initials: GD
authors.lastname: Fave
authors.affiliation: Digestive and Liver Disease Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology,"Sapienza" University of Rome, 00189 Rome, Italy. gabriele.capurso@gmail.com.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Capurso
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D009362:Neoplasm Metastasis; D009504:Neutrophils / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000473:pathology; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor
keywords: biomarkers; chemotherapy; neutrophil/lymphocyte ratio; pancreatic cancer; prognosis