Postoperative peripheral absolute blood lymphocyte-to-monocyte ratio predicts therapeutic outcome after pancreatic resection in patients with pancreatic adenocarcinoma

Yuki Fujiwara; Takeyuki Misawa; Hiroaki Shiba; Yoshihiro Shirai; Ryota Iwase; Koichiro Haruki; Kenei Furukawa; Yasuro Futagawa; Katsuhiko Yanaga

Postoperative peripheral absolute blood lymphocyte-to-monocyte ratio predicts therapeutic outcome after pancreatic resection in patients with pancreatic adenocarcinoma

Anticancer Res. 2014 Sep;34(9):5163-8.

Authors

Yuki Fujiwara¹, Takeyuki Misawa², Hiroaki Shiba², Yoshihiro Shirai², Ryota Iwase², Koichiro Haruki², Kenei Furukawa², Yasuro Futagawa², Katsuhiko Yanaga²

Affiliations

¹ Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan [email protected].
² Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

PMID: 25202109

Abstract

Aim: The aim of this study was to evaluate the significance of postoperative peripheral absolute blood lymphocyte-to-monocyte (ALC/AMC) ratio in pancreatic resections for pancreatic carcinoma.

Patients and methods: One hundred eleven patients who underwent pancreatic resection for pancreatic carcinoma were included in this study. We retrospectively examined perioperative findings as predictors of therapeutic outcome and the relation between postoperative ALC/AMC ratio and recurrence rate as well as overall survival of the patients with pancreatic carcinoma.

Results: In univariate analysis, advanced tumor-node-metastasis (TNM) classification (p=0.0002), intraoperative flesh-frozen plasma (FFP) transfusion (p=0.0395), increased in preoperative serum carbohydrate antigen 19-9 (CA19-9) (p=0.0051) and lower postoperative ALC/AMC ratio (p=0.0007) were positively associated with poor disease-free survival. Advanced TNM classification (p=0.0008), intraoperative FFP transfusion (p=0.0343), elevated postoperative serum C-reactive protein (CRP) (p=0.0165) and lower postoperative ALC/AMC ratio (p=0.0029), as well as decreased preoperative lymphocyte counts (p=0.0248) were positively associated with poor overall survival. In multivariate analysis, advanced TNM classification (p=0.007), intraoperative FFP transfusion (p=0.0197), increase in preoperative serum CA19-9 (p=0.0075) and lower postoperative ALC/AMC ratio (p=0.0051) were independent factors for poor disease-free survival. Advanced TNM classification (p=0.0083), lower postoperative ALC/AMC ratio (p=0.0070) and elevated postoperative serum CRP (p=0.0094) were independent factors for poor overall survival.

Conclusion: Lower postoperative peripheral ALC/AMC ratio may have a negative impact on recurrence and overall survival after pancreatic resection for pancreatic carcinoma.

Keywords: Lymphocyte-to-monocyte ratio; pancreatic adenocarcinoma; pancreatic resection; prognosis.

MeSH terms

Adenocarcinoma / blood*
Adenocarcinoma / mortality*
Adenocarcinoma / pathology
Adenocarcinoma / surgery
Adult
Aged
Female
Humans
Leukocyte Count*
Lymphocytes*
Male
Middle Aged
Monocytes*
Neoplasm Staging
Pancreatic Neoplasms / blood*
Pancreatic Neoplasms / mortality*
Pancreatic Neoplasms / pathology
Pancreatic Neoplasms / surgery
Postoperative Period
Prognosis
Treatment Outcome