RT Journal Article
SR Electronic
T1 Lymphocyte–to–Monocyte Ratio and Prognostic Nutritional Index Predict Poor Prognosis in Patients on Chemotherapy for Unresectable Pancreatic Cancer
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 2169
OP 2176
DO 10.21873/anticanres.13331
VO 39
IS 4
A1 TETSUNOSUKE SHIMIZU
A1 KOHEI TANIGUCHI
A1 MITSUHIRO ASAKUMA
A1 ATSUSHI TOMIOKA
A1 YOSHIHIRO INOUE
A1 KOJI KOMEDA
A1 FUMITOSHI HIROKAWA
A1 KAZUHISA UCHIYAMA
YR 2019
UL http://ar.iiarjournals.org/content/39/4/2169.abstract
AB Background/Aim: Recently, several systemic inflammation-based scores, such as neutrophil–to–lymphocyte ratio (NLR), platelet–to–lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), modified Glasgow prognostic score (GPS), and prognostic nutritional index (PNI), have been proposed as prognostic factors for several cancers. In this study, we aimed to determine the influence of systemic inflammation-based scores and nutrition status on the outcome in patients receiving chemotherapy for unresectable pancreatic cancer. Patients and Methods: A total of 93 consecutive patients who underwent chemotherapy for unresectable pancreatic cancer at Osaka Medical College Hospital, Takatsuki, Japan, between January 2008 and December 2014 were eligible for this study. The outcomes assessment included one- and two-year overall survival (OS) rates, according to changes in LMR and PNI prior to, and following chemotherapy. Results: LMR<3.4 (OR=5.02, 95%CI=1.559-19.85, p=0.005) and PNI<43 (OR=3.53, 95%CI=1.057-14.21, p=0.03) independently predicted a poor outcome in patients receiving chemotherapy for unresectable pancreatic cancer using multivariate analysis. According to changes in LMR and PNI prior to, and following chemotherapy, compared to patients who maintained LMR≥3.4, patients whose LMR decreased from ≥3.4 to <3.4 had significantly lower OS rates (p<0.001). Similarly, compared to patients who maintained PNI≥43, patients whose PNI deteriorated had significantly lower OS rates (56.2% versus 25.8% at one year, and 12.5% versus 0% at two years; p=0.003). Conclusion: LMR<3.4 and PNI<43 are identified as independent predictors of poor outcome in patients receiving chemotherapy for unresectable pancreatic cancer. LMR and PNI may help clinicians identify patients at high risk for poor prognosis.