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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2018

01-01-2018 | Endocrine Tumors

Markers of Systemic Inflammatory Response are Prognostic Factors in Patients with Pancreatic Neuroendocrine Tumors (PNETs): A Prospective Analysis

Authors: Apostolos Gaitanidis, MD, Dhaval Patel, MD, Naris Nilubol, MD, Amit Tirosh, MD, Samira Sadowski, MD, Electron Kebebew, MD

Published in: Annals of Surgical Oncology | Issue 1/2018

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Abstract

Background

The prognosis and behavior of pancreatic neuroendocrine tumors (PNETs) vary and may be divergent even at the same stage or tumor grade. Markers of systemic inflammatory response are readily available and are inexpensive, and have been shown to be prognostic factors in several cancers.

Objective

The aim of this study was to evaluate the prognostic utility of markers of systemic inflammatory response in patients with PNETs.

Methods

A prospective study of 97 patients with PNETs was performed (median follow-up of 15 months, range 12–73 months). Neutrophil-to-lymphocyte ratios (NLRs) and lymphocyte-to-monocyte ratios (LMRs) were calculated at baseline and preoperatively. The primary outcome measures were progression-free survival (PFS) and recurrence-free survival (RFS) after curative resection.

Results

Among all patients, an NLR > 2.3 [hazard ratio (HR) 2.53, 95% confidence interval (CI) 1.05–6.08, p = 0.038] and the presence of distant metastases (HR 2.8, 95% CI 1.26–6.21, p = 0.012) were independent predictors of disease progression. Among patients who did not undergo surgery during the study period, both platelet-to-lymphocyte ratio (PLR) > 160.9 (HR 5.86, 95% CI 1.27–27.08, p = 0.023) and mean platelet volume > 10.75 fL (HR 6.63, 95% CI 1.6–27.48, p = 0.009) were independently associated with worse PFS on multivariable analysis. Among patients who underwent complete resection, an LMR < 3.46 was associated with a worse RFS (HR 9.72, 95% CI 1.19–79.42, p = 0.034).

Conclusions

PLR > 160.9 and an MPV > 10.75 fL at baseline are independent predictors of disease progression, while an LMR < 3.46 is an independent predictor of tumor recurrence after complete resection in patients with PNETs.
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Metadata
Title
Markers of Systemic Inflammatory Response are Prognostic Factors in Patients with Pancreatic Neuroendocrine Tumors (PNETs): A Prospective Analysis
Authors
Apostolos Gaitanidis, MD
Dhaval Patel, MD
Naris Nilubol, MD
Amit Tirosh, MD
Samira Sadowski, MD
Electron Kebebew, MD
Publication date
01-01-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-6241-4

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