• Lucia Romano, Antonio Giuliani, Chiara Tomarelli, Andrea Nervini, Gianni Lazzarin, Beatrice Pessia, Vincenzo Vicentini, Francesco Carlei, and Mario Schietroma.
• Department of Biotechnological and Applied Clinical Sciences, General Surgery, University of L'Aquila, Department of Surgery, San Salvatore Hospital, L'Aquila, Italy.
• Med Princ Pract. 2022 Jan 1; 31 (6): 586594586-594.

BackgroundPancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis. The outcomes of patients with cancer are determined not only by tumor-related factors but also by systemic inflammatory response. The objective of the study was to identify whether the preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with the prognosis of PDAC of the pancreas head after curative pancreatoduodenectomy.Materials And MethodsSeventy-six patients were enrolled in this prospective, observational clinical study. The optimal NLR and PLR cut-off values were calculated using a receiver operating characteristic (ROC) curve analysis. ROC curve analysis revealed an optimal NLR and PLR cut-off point of 5.41 and 205.56, respectively. Consequently, the NLR and PRL scores were classified as NLR <5.41 or ≥5.41 and PLR <205.56 or ≥205.56. The clinical outcomes of overall survival (OS) and disease-free survival (DFS) were calculated by Kaplan-Meier survival curves. Univariate and multivariate analyses were performed to analyze the prognostic value of NLR and PLR.ResultsLow preoperative NLR and PLR levels both correlated with better pathological features, including decreased depth of invasion (p < 0.001), less lymph node metastasis (p < 0.001), earlier stage (p < 0.001), and lymphovascular invasion (p = 0.004). Kaplan-Meier plots illustrated that higher preoperative NLR and PLR had does not influence OS and DFS. Univariate analysis revealed that depth of invasion, lymph node metastasis, stage, PLR, and NLR are risk factors affecting OS and DFS. Multivariate analysis revealed that only stage was independently associated with OS and DFS.ConclusionsNLR and PLR measurements cannot provide important prognostic results in patients with resectable PDAC.© 2022 The Author(s). Published by S. Karger AG, Basel.

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