The association of pre-treatment peripheral blood markers with survival in patients with pancreatic cancer.

BACKGROUND/AIMS: The aim of the study is to assess the prognostic value of pretreatment lymphocyte, neutrophil, platelet counts, mean platelet volume (MPV), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) in patients with pancreatic cancer. METHODOLOGY: A total of 65 eligible patients were included in the study and retrospectively reviewed. Pre-treatment hematological parameters (platelet, lymphocyte, neutrophil counts, and mean platelet volume) and tumor marker (CA 19-9) levels were recorded. NLR was calculated by dividing the neutrophil count value by the number of lymphocytes. PLR was also calculated in a similar manner by dividing the platelet count value by the number of lymphocytes. RESULTS: One-year survival was 22.3% and the median survival time was 7 months (95% CI, 5.7-8.2) in the study group. Patients with a NLR value of < 5 had a significantly higher median survival duration compared to those with a NLR value of > or = 5 (p = 0.015). All other hematological variables were not significantly different. CONCLUSIONS: In patients with pancreatic cancer, pretreatment NLR may be use as a prognostic factor in pancreatic cancer patients. Further studies with larger patient cohorts are warranted to to better clarify the prognostic value of pre-treatment peripheral blood counts in patients with cancer.

The effect of peripheral blood values on prognosis of patients with locally advanced gastric cancer before treatment.

We aimed to investigate the prognostic significance of neutrophil, lymphocyte, platelet, mean platelet value (MPV), platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in patients with locally advanced gastric cancer (LAGC). One hundred sixty-eight patients with LAGC who had been followed-up between 2004 and 2008 were included in present study. The results of hematological (platelet, lymphocyte, neutrophil and MPV) and biochemical (uric acid and LDH) parameters were evaluated before treatment. NLR was divided into two groups as <2.56 and ≥2.57 and PLR was also divided into two groups as ≤160 and >160. Platelet counts and lymphocyte counts were also divided into two groups; ≤300.000/mm3 and >300.000/mm3, and <1,500/mm3 and ≥1,500/mm3, respectively. Results were evaluated with Kaplan-Meier and Long-rank tests. The mean age of patients at diagnosis was 60.1±12.1 and 114 of patients (67.8%) were male. For 168 patients, 48 months overall survival (OS) rate was 45.2% and the median OS was 39 months (range 33-44). In patients whose PLR was less than 160 (n=54), the median OS was 45 months (range 38-52) and also for cases whose PRL was greater than 160 (n=114), the median OS was 27 months (range 22-32) (p=0.006). While for fifty patients whose lymphocyte counts were less than 1,500, the median OS was 27 months (range 21-33), in cases with high lymphocyte counts (≥1,500) (n=118), it was 41 months (range 35-48) (p=0.03). The median OS was 41 (range 34-48) and 30 (range 23-37) months in two platelets groups, respectively (p=0.24). However, in the patients whose NLR was less than 2.56 (n=107), median OS was better than with cases whose NLR was greater than or equal to 2.56 (42 vs. 27 months). Routine peripheral blood counts may be useful prognostic factor for evaluating the accuracy of risk stratification in patients with radically resected gastric cancer Our results need to be confirmed by study including larger sample size in future.