Changes in total lymphocyte count and neutrophil-to-lymphocyte ratio after curative pancreatectomy in patients with pancreas adenocarcinoma and their prognostic role.
Journal: 2019/October - Journal of Surgical Oncology
ISSN: 1096-9098
Abstract:
To assess the prognostic significance of postoperative changes in immune status represented by total lymphocyte count (TLC) and neutrophil-to-lymphocyte ratio (NLR) in resectable pancreatic cancer.Patients who underwent curative pancreatectomy for pancreatic adenocarcinoma were divided into high and low groups according to cut-off values of TLC, and NLR measured preoperatively, immediately after surgery, and 1 or 6 months after surgery. Oncologic outcomes were compared between the two groups at different times, and prognostic roles of TLC and NLR were evaluated.

RESULTS
Of 193 patients, the median follow-up time was 22 months, and median survival was 18 months. Their immunologic status deteriorated within 3 to 4 days after the operation and recovered after that. At 1 and 6 months postoperatively, overall survival rates were significantly lower in the group with high NLR (>2.535 and >3.21, respectively) and low TLC (<1.66 × 109 and <1.62 × 109 /L, respectively). In multiple regression analyses, elevated NLR at postoperative 1 and 6 months and decreased TLC at postoperative 1 month were significant prognosis predictors.

Changes in immune status such as decreased TLC and elevated NLR at postoperative 1 and 6 months are effective prognostic predictors after curative pancreatectomy in patients with pancreatic adenocarcinoma.
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