Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma

Smith, Richard A.; Bosonnet, Lorraine; Raraty, Michael; Sutton, Robert; Neoptolemos, John P.; Campbell, Fiona; Ghaneh, Paula

doi:10.1016/j.amjsurg.2007.12.057

« Previous Next »The American Journal of Surgery
Volume 197, Issue 4 , Pages 466-472, April 2009

Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma

Richard A. Smith, M.R.C.S.
- Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby St., Liverpool, L69 3GA, UK
- Corresponding author. Tel.: +00-44-0151-7063898; fax: +00-44-0151-7065826
Lorraine Bosonnet, P.G.Dip.
- Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby St., Liverpool, L69 3GA, UK
Michael Raraty, F.R.C.S.
- Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby St., Liverpool, L69 3GA, UK
Robert Sutton, F.R.C.S.
- Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby St., Liverpool, L69 3GA, UK
John P. Neoptolemos, F.R.C.S.
- Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby St., Liverpool, L69 3GA, UK
Fiona Campbell, F.R.C.Path.
- Department of Pathology, School of Cancer Studies, Royal Liverpool University Hospital, Liverpool, UK
Paula Ghaneh, F.R.C.S.
- Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby St., Liverpool, L69 3GA, UK

Received 10 October 2007; received in revised form 6 December 2007 published online 22 July 2008.

Abstract

Background

The objective of this study was to investigate whether the preoperative platelet-lymphocyte (P/L) ratio represents a significant prognostic index in resected pancreatic ductal adenocarcinoma.

Methods

A total of 110 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a prospectively maintained database.

Results

The preoperative P/L ratio was found to be a more significant prognostic marker (P < .001) than either the lymphocyte count (P = .007) or platelet count (P = .068) on univariate Cox survival analysis. The median overall survival in patients with a P/L ratio of 150 or less (n = 48) was 19.7 months, 13.7 months in those with a P/L ratio of 151 to 300 (n = 43), and 5.8 months in patients with a value of greater than 300 (n = 19) (log-rank, P = .006). The preoperative P/L ratio retained significance on multivariate analysis (P < .001), along with tumor size (P = .010) and lymph node ratio (P = .013).