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Surgery Today
Published in: Surgery Today 5/2016

01-05-2016 | Original Article

Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil-lymphocyte and platelet-lymphocyte ratios

Authors: Sadaki Asari, Ippei Matsumoto, Hirochika Toyama, Makoto Shinzeki, Tadahiro Goto, Jun Ishida, Tetsuo Ajiki, Takumi Fukumoto, Yonson Ku

Published in: Surgery Today | Issue 5/2016

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Abstract

Purpose

The therapeutic strategy for borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) has remained unestablished because the preoperative prognostic factors have not been determined.

Methods

One hundred eighty-four consecutive PDAC patients who underwent upfront surgery with a curative resection between January 2000 and June 2013 at Kobe University Hospital were retrospectively studied. The PDAC patients were stratified into resectable (R)-PDAC (n = 147) and BR-PDAC patients (n = 37). We evaluated the independent prognostic significance of the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) in the BR-PDAC patients.

Results

BR-PDAC patient survival was significantly worse than R-PDAC patient survival (median survival time: 22.1 months vs. 24.3 months; 5-year survival rate 6 vs. 21 %; P = 0.042). The median survival in BR-PDAC patients with a preoperative NLR of >3 (n = 12) was 10.2 months, while that in patients with preoperative NLR of ≤3 (n = 25) was 24.9 months (P = 0.002). Moreover, the median survival in BR-PDAC patients with a preoperative PLR of >225 (n = 8) was 10.2 months, while that in patients with a preoperative PLR of ≤225 (n = 29) was 24.7 months (P = 0.003). Preoperative NLR >3 (HR = 2.980, 95 % CI 1.251–6.920; P = 0.015) and PLR >225 (HR = 3.050, 95 % CI 1.169–7.468; P = 0.024) were independent prognostic factors in BR-PDAC patients.

Conclusions

Higher preoperative NLR and PLR can be independent predictive risk factors in BR-PDAC patients following curative resection.
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Metadata
Title
Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil-lymphocyte and platelet-lymphocyte ratios
Authors
Sadaki Asari
Ippei Matsumoto
Hirochika Toyama
Makoto Shinzeki
Tadahiro Goto
Jun Ishida
Tetsuo Ajiki
Takumi Fukumoto
Yonson Ku
Publication date
01-05-2016
Publisher
Springer Japan
Published in
Surgery Today / Issue 5/2016
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1206-3

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