The American Journal of Surgery
Volume 200, Issue 2 , Pages 197-203, August 2010

Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio

  • Imran Bhatti, M.B.Ch.B., M.R.C.S.

      Affiliations

    • Division of Surgery, School of Graduate Entry Medicine and Health, University of Nottingham Medical School at, Derby, Derby City General Hospital, Derby DE22 3DT, UK
    • Corresponding Author InformationCorresponding author: Tel.: +44-33-272-4702; fax: +01-33-272-4697
    • ,
  • Oliver Peacock, B.Med.Sci.

      Affiliations

    • Department of Surgery, Derby City General Hospital, Derby, UK
    • ,
  • Gareth Lloyd, B.Med.Sci.

      Affiliations

    • Department of Surgery, Derby City General Hospital, Derby, UK
    • ,
  • Michael Larvin, M.D., F.R.C.S.

      Affiliations

    • Division of Surgery, School of Graduate Entry Medicine and Health, University of Nottingham Medical School at, Derby, Derby City General Hospital, Derby DE22 3DT, UK
    • ,
  • Richard I. Hall, M.D., F.R.C.S.

      Affiliations

    • Department of Surgery, Derby City General Hospital, Derby, UK

Received 3 June 2009; received in revised form 11 August 2009 published online 01 February 2010.

Abstract 

Background

The objective of this study was to investigate whether the preoperative hematologic markers, the platelet-lymphocyte ratio (PLR), or the neutrophil-lymphocyte ratio (NLR) ratio are significant prognostic indicators in resected pancreatic ductal adenocarcinoma.

Methods

A total of 84 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a retrospectively maintained database.

Results

The preoperative NLR was found to be a significant prognostic marker (P = .023), whereas PLR had no significant relationship with survival (P = .642) using univariate Cox survival analysis. The median overall survival in patients with an NLR of ≤3.0 (n = 55) was 13.7, 17.0 months in those with an NLR of 3.0 to 4.0 (n = 17) and 5.9 months in patients with a value of >4.0 (n = 12) (log rank, P = .016). The NLR retained its significance on multivariate analysis (P = .039) along with resection margin status (P = .001).

Conclusion

The preoperative NLR represents a significant independent prognostic indicator in patients with resected pancreatic ductal adenocarcinoma, whereas PLR does not.

Keywords: Preoperative markers, Neutrophil-lymphocyte ratio, Prognosis, Pancreatic cancer

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PII: S0002-9610(09)00791-0

doi:10.1016/j.amjsurg.2009.08.041

The American Journal of Surgery
Volume 200, Issue 2 , Pages 197-203, August 2010

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