Faculty Collaboration Database

Markers of Systemic Inflammatory Response are Prognostic Factors in Patients with Pancreatic Neuroendocrine Tumors (PNETs): A Prospective Analysis. Ann Surg Oncol 2018 Jan;25(1):122-130

Date

11/15/2017

Pubmed ID

29134377

Pubmed Central ID

PMC8054768

DOI

10.1245/s10434-017-6241-4

Scopus ID

2-s2.0-85033568707 (requires institutional sign-in at Scopus site)   43 Citations

Abstract

BACKGROUND: The prognosis and behavior of pancreatic neuroendocrine tumors (PNETs) vary and may be divergent even at the same stage or tumor grade. Markers of systemic inflammatory response are readily available and are inexpensive, and have been shown to be prognostic factors in several cancers.

OBJECTIVE: The aim of this study was to evaluate the prognostic utility of markers of systemic inflammatory response in patients with PNETs.

METHODS: A prospective study of 97 patients with PNETs was performed (median follow-up of 15 months, range 12-73 months). Neutrophil-to-lymphocyte ratios (NLRs) and lymphocyte-to-monocyte ratios (LMRs) were calculated at baseline and preoperatively. The primary outcome measures were progression-free survival (PFS) and recurrence-free survival (RFS) after curative resection.

RESULTS: Among all patients, an NLR > 2.3 [hazard ratio (HR) 2.53, 95% confidence interval (CI) 1.05-6.08, p = 0.038] and the presence of distant metastases (HR 2.8, 95% CI 1.26-6.21, p = 0.012) were independent predictors of disease progression. Among patients who did not undergo surgery during the study period, both platelet-to-lymphocyte ratio (PLR) > 160.9 (HR 5.86, 95% CI 1.27-27.08, p = 0.023) and mean platelet volume > 10.75 fL (HR 6.63, 95% CI 1.6-27.48, p = 0.009) were independently associated with worse PFS on multivariable analysis. Among patients who underwent complete resection, an LMR < 3.46 was associated with a worse RFS (HR 9.72, 95% CI 1.19-79.42, p = 0.034).

CONCLUSIONS: PLR > 160.9 and an MPV > 10.75 fL at baseline are independent predictors of disease progression, while an LMR < 3.46 is an independent predictor of tumor recurrence after complete resection in patients with PNETs.

Author List

Gaitanidis A, Patel D, Nilubol N, Tirosh A, Sadowski S, Kebebew E

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Area Under Curve
Biomarkers
Disease Progression
Disease-Free Survival
Female
Humans
Inflammation
Lymphocyte Count
Male
Mean Platelet Volume
Middle Aged
Monocytes
Neuroendocrine Tumors
Neutrophils
Pancreatic Neoplasms
Platelet Count
Postoperative Period
Predictive Value of Tests
Preoperative Period
Prospective Studies
ROC Curve
Young Adult