BACKGROUND AND OBJECTIVES: Several serum based-markers and ratios have been investigated for their prognostic value in pancreatic ductal adenocarcinoma (PDAC). This cohort study aimed to combine these into a novel prognostic scoring system. METHODS: A retrospective cohort study was performed on 145 patients with unresectable histologically-confirmed PDAC. Based on the existing literature the following markers were investigated: neutrophil-lymphocyte ratio (NLR), neutrophil-albumin ratio (NAR), platelet-lymphocyte ratio (PLR), fibrinogen, and Ca19-9. These values were dichotomized about their medians for Kaplan-Meier and Cox regression analysis. RESULTS: Univariate Cox regression revealed statistically significant prognostic value for: NLR, NAR, PLR, fibrinogen, and Ca19-9. When combining these using Cox regression analysis adjusting for other prognostic indicators, only NAR (hazard ratios [HR] = 3.174, P = 0.022) and Ca19-9 (HR = 2.697, P = 0.031) were independent predictors of survival. Combining NAR and Ca19-9 we split the cohort into three "NARCA" groups: NARCA0 = NAR ≤ 0.13 and Ca19-9 ≤ 770, NARCA1 = either NAR > 0.13 or Ca19-9 >770, NARCA2 = NAR > 0.13 and Ca19-9 > 770. Median survival was 20.5, 9.7 and 4.1 months in NARCA0, 1, and 2 respectively ( P < 0.0005, log-rank test). A separate validation cohort confirmed the prognostic significance of the score ( P = 0.048). CONCLUSIONS: Combining NAR and Ca19-9 into a prognostic score allows stratification of unresectable PDAC patients into groups with significantly different overall survival.
BACKGROUND AND OBJECTIVES: Several serum based-markers and ratios have been investigated for their prognostic value in pancreatic ductal adenocarcinoma (PDAC). This cohort study aimed to combine these into a novel prognostic scoring system. METHODS: A retrospective cohort study was performed on 145 patients with unresectable histologically-confirmed PDAC. Based on the existing literature the following markers were investigated: neutrophil-lymphocyte ratio (NLR), neutrophil-albumin ratio (NAR), platelet-lymphocyte ratio (PLR), fibrinogen, and Ca19-9. These values were dichotomized about their medians for Kaplan-Meier and Cox regression analysis. RESULTS: Univariate Cox regression revealed statistically significant prognostic value for: NLR, NAR, PLR, fibrinogen, and Ca19-9. When combining these using Cox regression analysis adjusting for other prognostic indicators, only NAR (hazard ratios [HR] = 3.174, P = 0.022) and Ca19-9 (HR = 2.697, P = 0.031) were independent predictors of survival. Combining NAR and Ca19-9 we split the cohort into three "NARCA" groups: NARCA0 = NAR ≤ 0.13 and Ca19-9 ≤ 770, NARCA1 = either NAR > 0.13 or Ca19-9 >770, NARCA2 = NAR > 0.13 and Ca19-9 > 770. Median survival was 20.5, 9.7 and 4.1 months in NARCA0, 1, and 2 respectively ( P < 0.0005, log-rank test). A separate validation cohort confirmed the prognostic significance of the score ( P = 0.048). CONCLUSIONS: Combining NAR and Ca19-9 into a prognostic score allows stratification of unresectable PDACpatients into groups with significantly different overall survival.
Authors: Matteo Ferro; Dragoş-Florin Babă; Ottavio de Cobelli; Gennaro Musi; Giuseppe Lucarelli; Daniela Terracciano; Angelo Porreca; Gian Maria Busetto; Francesco Del Giudice; Francesco Soria; Paolo Gontero; Francesco Cantiello; Rocco Damiano; Papalia Rocco; Roberto Mario Scarpa; Abdal Rahman Abu Farhan; Riccardo Autorino; Antonio Brescia; Michele Marchioni; Andrea Mari; Andrea Minervini; Nicola Longo; Francesco Chiancone; Sisto Perdona'; Biagio Barone; Pietro De Placido; Michele Catellani; Danilo Bottero; Pasquale Ditonno; Michele Battaglia; Stefania Zamboni; Alessandro Antonelli; Francesco Greco; Giorgio Ivan Russo; Salvatore Smelzo; Rodolfo Hurle; Nicolae Crisan; Matteo Manfredi; Francesco Porpiglia; Felice Crocetto; Carlo Buonerba; Alina Danilesco; Mihai Dorin Vartolomei Journal: Future Sci OA Date: 2021-04-20