Prognostic value of inflammation-based scores and TNM stage for pancreatic cancer patients after radical resection / 中华胰腺病杂志

ABSTRACT

Objective To compare the prognostic value of different inflammation-based prognostic scores and Tumor Node Metastasis ( TNM) stage for patients undergoing radical resection of pancreatic cancer with the routine TNM stage in clinical practice.Methods Clinical data of 185 patients with pancreatic cancer who underwent radical surgery were retrospectively analyzed.Based on the inflammation-based prognostic scores ( Glasgow prognostic score ( GPS ) , neutrophil lymphocyte ratio ( NLR ) , platelet lymphocyte ratio ( PLR) , prognostic nutritional index ( PNI ) and prognostic index ( PI ) ) before surgery, univariate and multivariate analyses were used for identifying influential factors on patients′survival.Homogeneity of different scoring systems was compared using likelihood ratio chi-quare test, and linear trend chi-square test, and receiver operating characteristic ( ROC) curve were performed to compare the differentiating ability and single trend of the selected scores with those of routine TNM stage.Results In univariate analysis, preoperative weight loss, serum C-reactive protein, serum albumin, CA19-9, radical surgery, NLR, PLR, GPS, PI, PNI and TNM stage were all significantly associated with patients′overall survival after surgery (P<0.001).In multivariate cox risk model analysis, TNM stage, radical surgery, GPS, NLR, PLR, PI and PNI were independent risk factors for patients′survival after surgery.ROC curve showed that GPS had higher AUC than other scoring systems, but TNM stage had the highest AUC.The homogeneity, differentiating ability and single trend of GPS were higher compared to other inflammation-based prognostic scores, but those of TNM stage were the highest.Conclusions The inflammation-based prognostic scores like GPS, NLR, PLR, PI and PNI were independent prognostic factors for pancreatic caner patients′survival after surgery, and the prognostic value of GPS was superior to that of NLR, PLR, PI and PNI.