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Inflammatory markers as prognostic indicators in pancreatic cancer patients who underwent gemcitabine-based palliative chemotherapy

Korean Journal of Internal Medicine 2020년 35권 1호 p.171 ~ 184
김홍전 ( Kim Hong-Jun ) - Korea University College of Medicine Department of Internal Medicine

이숙영 ( Lee Suk-Young ) - Korea University College of Medicine Department of Internal Medicine
김대식 ( Kim Dae-Sik ) - Korea University College of Medicine Department of Internal Medicine
강은주 ( Kang Eun-Joo ) - Korea University College of Medicine Department of Internal Medicine
김정순 ( Kim Jung-Sun ) - Korea University College of Medicine Department of Internal Medicine
최윤지 ( Choi Yoon-Ji ) - Korea University College of Medicine Department of Internal Medicine
오상철 ( Oh Sang-Cheul ) - Korea University College of Medicine Department of Internal Medicine
서재홍 ( Seo Jae-Hong ) - Korea University College of Medicine Department of Internal Medicine
김준석 ( Kim Jun-Suk ) - Korea University College of Medicine Department of Internal Medicine

Abstract


Background/Aims: Patients with pancreatic cancer (PC) generally have poor clinical outcomes. Early determination of their prognosis is crucial for developing a therapeutic strategy. Recently, various inflammatory markers have been validated as prognostic indicators for many cancers, including PC. However, few studies have evaluated these markers together. Thus, the purpose of this study was to comprehensively evaluate the value of inflammatory markers as prognostic indicators in patients with advanced PC treated with gemcitabine-based chemotherapy as the first line regimen.

Methods: This was a single-center retrospective study evaluating 302 patients with advanced PC who began first line treatment between November 2004 and August 2016. These patients were monitored until June 2017. Survival rates were assessed with univariate and multivariate analyses. Continuous variables were separated using the normal range or ideal cut-off levels determined by receiver operating curve analyses.

Results: Among inflammatory markers evaluated, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and C-reactive protein (CRP) to albumin ratio (CRP-albumin ratio) were independent predictors of overall survival (hazard ratio, 1.712, 1.345, and 1.454, respectively). Difference in survival rates was significant (p < 0.001) among three groups divided by the number of marker-related risks.

Conclusions: Baseline inflammatory markers including NLR, PLR, and CRP-albumin ratio are useful in predicting survival rates in patients with PC. Combining these three markers is proven to be valuable.

키워드

Inflammation; Pancreatic neoplasms; Prognosis
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