Open AccessNeutrophil‐to‐lymphocyte ratio for predicting palliative chemotherapy outcomes in advanced pancreatic cancer patients
Author(s) -
Xue Peng,
Kanai Masashi,
Mori Yukiko,
Nishimura Takafumi,
Uza Norimitsu,
Kodama Yuzo,
Kawaguchi Yoshiya,
Takaori Kyoichi,
Matsumoto Shigemi,
Uemoto Shinji,
Chiba Tsutomu
Publication year - 2014
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.204
Subject(s) - medicine , carcinoembryonic antigen , chemotherapy , hazard ratio , gastroenterology , proportional hazards model , palliative chemotherapy , oncology , pancreatic cancer , confidence interval , neutrophil to lymphocyte ratio , stage (stratigraphy) , cancer , lymphocyte , paleontology , biology
Several previous studies reported that the neutrophil‐to‐lymphocyte ratio ( NLR ) could be a promising prognostic factor for patients with cancer. We aimed to determine the prognostic value of NLR in patients with advanced pancreatic cancer ( APC ) following palliative chemotherapy. We retrospectively reviewed 252 consecutive APC patients receiving palliative chemotherapy between January 2006 and December 2012. We classified the patients according to the pretreatment NLR values (≤5 or >5) into two groups and investigated the difference in treatment outcomes, including time to treatment failure ( TTF ) and overall survival ( OS ). A total of 212 patients had pretreatment NLR values of ≤5 (group A), while 40 patients had an NLR of >5 (group B). TTF and OS were significantly shorter in group B than in group A (3.1 vs. 8.7 months and 6.0 vs. 12.8 months, respectively; both P < 0.01). After adjustment for putative prognostic factors, including distant metastasis, status of recurrent/unresectable disease, pretreatment carbohydrate antigen 19‐9 levels, and carcinoembryonic antigen levels using the Cox regression model, elevated pretreatment NLR remained an independent poor prognostic factor for OS (hazard ratio, 1.92; 95% confidence interval, 1.27–2.90; P < 0.01). In addition, patients in group B whose NLR dropped to ≤5 before the second cycle of chemotherapy showed longer TTF and OS compared with those whose NLR remained at >5. Our results support the idea that NLR can be a promising prognostic and predictive marker for APC patients receiving palliative chemotherapy.