Lu JN, Zhou LS, Zhang S, Li JX, Xu CJ. Performance of nutritional and inflammatory markers in patients with pancreatic cancer. World J Clin Oncol 2024; 15(8): 1021-1032 [PMID: 39193151 DOI: 10.5306/wjco.v15.i8.1021]
Corresponding Author of This Article
Cai-Juan Xu, MNurs, Chief Nurse, Professor, Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. xucaijuaneve@zju.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Cohort 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/
Jie-Nan Lu, Lu-Sha Zhou, Shuai Zhang, Jun-Xiu Li, Cai-Juan Xu, Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Lu JN and Xu CJ designed the research study; Lu JN, Zhou LS and Zhang S performed the research; Li JX and Zhang S contributed new reagents and analytic tools; Lu JN, Zhou LS and Xu CJ analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Supported byMedicine and Health Science and Technology Project of Zhejiang Province, No. 2021KY168.
Institutional review board statement: Ethical approval was obtained from the Ethics Committee of the Second Affiliated Hospital, Zhejiang University School of Medicine (No. 20240326).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no competing interests.
Data sharing statement: All data generated during this study are included in this published article and its supplementary information files.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cai-Juan Xu, MNurs, Chief Nurse, Professor, Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. xucaijuaneve@zju.edu.cn
Received: March 23, 2024 Revised: May 14, 2024 Accepted: July 9, 2024 Published online: August 24, 2024 Processing time: 145 Days and 18.6 Hours
Abstract
BACKGROUND
Systemic inflammation and nutrition play pivotal roles in cancer progression and can increase the risk of delayed recovery after surgical procedures.
AIM
To assess the significance of inflammatory and nutritional indicators for the prognosis and postoperative recovery of patients with pancreatic cancer (PC).
METHODS
Patients who were diagnosed with PC and underwent surgical resection at our hospital between January 1, 2019, and July 31, 2023, were enrolled in this retrospective observational cohort study. All the data were collected from the electronic medical record system. Seven biomarkers - the albumin-to-globulin ratio, prognostic nutritional index (PNI), systemic immune–inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), nutritional risk index (NRI), and geriatric NRI were assessed.
RESULTS
A total of 446 patients with PC met the inclusion criteria and were subsequently enrolled. Patients with early postoperative discharge tended to have higher PNI values and lower SII, NLR, and PLR values (all P < 0.05). Through multivariable logistic regression analysis, the SII value emerged as an independent risk factor influencing early recovery after surgery. Additionally, both univariable and multivariable Cox regression analyses revealed that the PNI value was the strongest prognostic marker for overall survival (OS; P = 0.028) and recurrence-free survival (RFS; P < 0.001). The optimal cutoff PNI value was established at 47.30 using X-tile software. Patients in the PNI-high group had longer OS (P < 0.001) and RFS (P = 0.0028) times than those in the PNI-low group.
CONCLUSION
Preoperative systemic inflammatory-nutritional biomarkers may be capable of predicting short-term recovery after surgery as well as long-term patient outcomes.
Core Tip: This recent study investigated the predictive capacity of preoperative inflammatory-nutritional biomarkers for postoperative recovery outcomes. The systemic immune-inflammation index is notable as an independent risk factor influencing early recovery following surgery. Additionally, our findings indicate correlations between preoperative inflammatory-nutritional biomarkers and prognosis in patients with pancreatic cancer. Among these biomarkers, the prognostic nutritional index showed the highest prognostic value.
