Lee JM, Lee HS, Hyun JJ, Choi HS, Kim ES, Keum B, Seo YS, Jeen YT, Chun HJ, Um SH, Kim CD. Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib. World J Gastrointest Oncol 2016; 8(7): 555-562 [PMID: 27559435 DOI: 10.4251/wjgo.v8.i7.555]
Corresponding Author of This Article
Hong Sik Lee, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 02841, South Korea. hslee60@korea.ac.kr
Research Domain of This Article
Allergy
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jul 15, 2016; 8(7): 555-562 Published online Jul 15, 2016. doi: 10.4251/wjgo.v8.i7.555
Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib
Jae Min Lee, Hong Sik Lee, Jong Jin Hyun, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim
Jae Min Lee, Hong Sik Lee, Jong Jin Hyun, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, South Korea
Author contributions: Lee HS designed the study; Lee JM and Hyun JJ modified the study methods and performed the study; Choi HS and Kim ES collected the data; Seo YS and Jeen YT analyzed the data; Lee JM wrote the draft; Keum B, Chun HJ, Um SH and Kim CD revised the draft; Lee HS corrected the final draft and approved the manuscript.
Supported by A grant of the Korea Health Technology R and D Project through the Korea Health Industry Development Institute (KHIDI); the Ministry of Health and Welfare, Republic of Korea, No. HI14C3477.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Korea University Anam Hospital.
Informed consent statement: We analyzed the clinical data from each patient who had provided written consent to receive treatment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hong Sik Lee, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 02841, South Korea. hslee60@korea.ac.kr
Telephone: +82-2-9205312 Fax: +82-2-9531943
Received: February 3, 2016 Peer-review started: February 9, 2016 First decision: March 31, 2016 Revised: April 8, 2016 Accepted: May 7, 2016 Article in press: May 9, 2016 Published online: July 15, 2016 Processing time: 155 Days and 12.2 Hours
Abstract
AIM: To evaluate the value of systemic inflammation-based markers as prognostic factors for advanced pancreatic cancer (PC).
METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein (CRP)-to-albumin (CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival (PFS) and overall survival (OS).
RESULTS: The univariate analysis demonstrated the prognostic value of the NLR (P = 0.049) and the CRP/Alb ratio (P = 0.047) in relation to PFS, and a positive relationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR (hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients’ prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > 5.
CONCLUSION: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.
Core tip: This retrospective study validates the value of systemic inflammation-based markers as prognostic factors for pancreatic cancer (PC). The neutrophil-to-lymphocyte ratio and the C-reactive protein-to-albumin ratio, which can be determined from routine blood tests before chemotherapy, can be used as useful biomarkers in PC to predict a patient’s response to chemotherapy.
