Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma

Background Preoperative nutritional and immunological patient factors have been found to be associated with prognostic outcomes of malignant tumors; however, the clinical significance of these factors in pancreatic ductal adenocarcinoma (PDAC) remains controversial. Objective The aim of this study w...

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Bibliographic Details
Published in:Annals of surgical oncology 2018-12, Vol.25 (13), p.3996-4003
Main Authors: Abe, Toshiya, Nakata, Kohei, Kibe, Shin, Mori, Yasuhisa, Miyasaka, Yoshihiro, Ohuchida, Kenoki, Ohtsuka, Takao, Oda, Yoshinao, Nakamura, Masafumi
Format: Article
Language:English
Subjects:
Adenocarcinoma
Aged
Carcinoembryonic Antigen - blood
Carcinoma, Pancreatic Ductal - blood
Carcinoma, Pancreatic Ductal - pathology
Disease-Free Survival
Female
Humans
Immunology
Lymphocyte Count
Lymphocytes
Male
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Monocytes
Multivariate analysis
Neoplasm Grading
Neoplasm Staging
Neutrophils
Nutrition Assessment
Nutritional Status
Oncology
Palliative Care
Pancreas
Pancreatic cancer
Pancreatic Neoplasms - blood
Pancreatic Neoplasms - surgery
Pancreatic Tumors
Patients
Platelet Count
Preoperative Period
Retrospective Studies
Surgery
Surgical Oncology
Survival Rate
Tumors
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Summary:Background Preoperative nutritional and immunological patient factors have been found to be associated with prognostic outcomes of malignant tumors; however, the clinical significance of these factors in pancreatic ductal adenocarcinoma (PDAC) remains controversial. Objective The aim of this study was to evaluate the prognostic value of nutritional and immunological factors in predicting survival of patients with PDAC. Methods Retrospective studies of 329 patients who underwent surgical resection for PDAC and 95 patients who underwent palliative surgery were separately conducted to investigate the prognostic impact of tumor-related factors and patient-related factors, including Glasgow Prognostic Score (GPS), modified GPS, Prognostic Nutritional Index (PNI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, and lymphocyte/monocyte ratio. Results In multivariate analysis for patients with surgical resection for PDAC, PNI was an independent factor for overall survival (OS) and disease-free survival. The median OS of patients with PNI ≤ 45 was significantly shorter than that of patients with PNI > 45 (17.5 and 36.2 months, respectively; p   5 was significantly shorter than that of patients with NLR ≤ 5 (2.7 and 8.9 months, respectively; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-018-6761-6