Annals of Medicine (Dec 2024)

Prognostic value of neutrophil to lymphocyte ratio in patients with advanced pancreatic ductal adenocarcinoma treated with systemic chemotherapy

  • Kensuke Kitsugi,
  • Kazuhito Kawata,
  • Hidenao Noritake,
  • Takeshi Chida,
  • Kazuyoshi Ohta,
  • Jun Ito,
  • Shingo Takatori,
  • Maho Yamashita,
  • Tomohiko Hanaoka,
  • Masahiro Umemura,
  • Moe Matsumoto,
  • Yoshifumi Morita,
  • Makoto Takeda,
  • Satoru Furuhashi,
  • Ryo Kitajima,
  • Ryuta Muraki,
  • Shinya Ida,
  • Akio Matsumoto,
  • Takafumi Suda

DOI
https://doi.org/10.1080/07853890.2024.2398725
Journal volume & issue
Vol. 56, no. 1

Abstract

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Objectives Although systemic chemotherapy for pancreatic ductal adenocarcinoma (PDAC) has made progress, ensuring long-term survival remains difficult. There are several reports on the usefulness of neutrophil-to-lymphocyte ratio (NLR) in predicting the prognosis of PDAC, but few reports in systemic chemotherapy. We hereby investigated the usefulness of NLR in systemic chemotherapy for PDAC.Materials and methods A retrospective study was conducted on patients with advanced PDAC treated with first-line systemic chemotherapy. Cox regression hazards models were performed to analyze the association between baseline patient characteristics and the initial treatment response, and overall survival (OS).Results A total of 60 patients with PDAC were enrolled. At baseline, there were significant differences in NLR and carbohydrate antigen 19-9 (CA19-9), as well as the selection rate of combination chemotherapy, between patients with partial response or stable disease and those with progressive disease. Univariate and multivariate analysis showed that NLR < 3.10, combination chemotherapy, and CA19-9 < 1011 U/mL were significant and independent predictive factors of the initial treatment response. Meanwhile, NLR < 3.10 and combination chemotherapy were independently associated with longer OS. Moreover, OS was significantly prolonged in patients with NLR < 3.10, regardless of whether combination chemotherapy or monotherapy. Patients with NLR < 3.10 at baseline had a significantly higher conversion rate to third-line chemotherapy and a longer duration of total chemotherapy.Conclusions This study suggests that NLR may be a useful marker for predicting the initial treatment response to first-line chemotherapy and the prognosis for patients with advanced PDAC.

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