演題

IS-8-8

Preoperative independent prognostic factors in patients with borderline resectable pancreatic adenocarcinoma following curative resection:Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio

[演者] 浅利 貞毅:1
[著者] 外山 博近:1, 後藤 直大:1, 石田 潤:1, 南野 佳英:1, 植田 亜津紗:1, 味木 徹夫:1, 松本 拓:1, 木戸 正浩:1, 福本 巧:1, 具 英成:1
1:神戸大学肝胆膵外科

Background: Borderline resectable pancreatic adenocarcinoma (BR-PAC) is defined as locally advanced tumor of the pancreas without metastasis that is, although potentially resectable (R), at high risk for positive resection margin following surgery. The therapeutic strategy has remained unestablished because BR-PAC is biologically a heterogeneous subset in which the preoperative prognostic factors are undetermined. Method: Between January 2003 and June 2012 at Kobe University Hospital, 136 consecutive pancreatic adenocarcinoma (PAC) patients who underwent surgical curative resection were retrospectively studied. Prior to surgery, the PAC patients were stratified into R- and BR-PAC patients according to the National Comprehensive Cancer Network guidelines. To evaluate the independent prognostic significance of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), univariate and multivariate Cox proportional-hazard models were applied.Results: The median survival in PAC patients with preoperative NLR>3 (n=45) and NLR=<3 (n=91) was 17.5 months and 31.1 months, respectively (P=0.0037). The median survival in BR-PAC patients with preoperative NLR>3 (n=7) and NLR=<3 (n=21) was 14.8 months and 27.2 months, respectively (P=0.0068). In addition, median survival in BR-PAC patients with preoperative PLR>225 (n=5) and PLR=<225 (n=23) was 14.8 months and 26.2 months, respectively (P=0.0050). Preoperative NLR>3 (HR=21.437, 95% CI=4.119-142.980; P=0.0002) and PLR>225 (HR=30.993, 95% CI=3.844-384.831; P=0.0009) were the only independent prognostic factors in BR-PAC patients.Conclusion: Preoperative NLR and PLR offer independent prognostic information regarding overall survival in BR-PAC patients following curative resection.
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