Prognostic indicators based on inflammatory and nutritional factors after pancreaticoduodenectomy for pancreatic cancer.
PURPOSE
We evaluated prognostic indicators based on inflammatory and nutritional factors, namely, the modified Glasgow Prognostic Score (mGPS), the Prognostic Nutritional Index (PNI), the neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR), to determine their efficiency and significance after pancreaticoduodenectomy for pancreatic cancer.


METHODS
The subjects of this study were 46 patients who underwent pancreaticoduodenectomy for pancreatic cancer between October 2007 and December 2014. Patients were divided into preoperative mGPS (0/1 and 2), PNI (<40 and ≥40), NLR (<2.5 and ≥2.5), and PLR (<200 and ≥200) groups, to evaluate various perioperative outcomes.


RESULTS
Hemoglobin concentrations were significantly lower (P = 0.019), whereas intra-abdominal bleeding was significantly higher (P = 0.040) in the PNI (<40) group than in the PNI (≥40) group. The incidence of postoperative pneumonia was significantly higher in the mGPS (2) group (P = 0.009), and surgical complications greater than grade 3 (Clavien-Dindo classification) were significantly increased in the NLR (≥2.5) group (P = 0.041). Overall survival rates in the PNI (<40) (P = 0.019), NLR (≥2.5) (P = 0.001), and PLR (≥200) (P < 0.001) groups were significantly lower than those in the other groups. The PLR was the only independent prognostic indicator (P = 0.002) according to multivariate analysis.


CONCLUSIONS
The mGPS, PNI, and NLR were effective predictive indicators of postoperative complications. The PLR was the most useful prognostic indicator for pancreatic cancer patients after pancreaticoduodenectomy.
['Watanabe|Joji|J|', 'Otani|Shinji|S|', 'Sakamoto|Teruhisa|T|', 'Arai|Yosuke|Y|', 'Hanaki|Takehiko|T|', 'Amisaki|Masataka|M|', 'Tokuyasu|Naruo|N|', 'Honjo|Soichiro|S|', 'Ikeguchi|Masahide|M|']
D000368:Aged D000369:Aged, 80 and over D005260:Female D023261:Glasgow Outcome Scale D006801:Humans D018655:Lymphocyte Count D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D009504:Neutrophils D015596:Nutrition Assessment D010190:Pancreatic Neoplasms D016577:Pancreaticoduodenectomy D010976:Platelet Count D011014:Pneumonia D011183:Postoperative Complications D011237:Predictive Value of Tests D011379:Prognosis D015996:Survival Rate
Prognostic indicator Pancreaticoduodenectomy Pancreatic cancer