Combined preoperative platelet-to-lymphocyte ratio and serum carbohydrate antigen 19-9 level as a prognostic factor in patients with resected pancreatic cancer.

BACKGROUND

Carbohydrate antigen 19-9 (CA19-9) is the most frequently used tumor marker and serves as a prognostic indicator in patients with pancreatic cancer (PC). The platelet-to-lymphocyte ratio (PLR) is thought to be an inflammation-related serum marker. An elevated PLR represents increased inflammatory status and is associated with poor prognosis in patients with various cancers including PC.

METHODS

This study involved 103 patients with a histopathological diagnosis of pancreatic ductal adenocarcinoma who underwent pancreatectomy. The patients were assessed to determine the prognostic significance of the combination of the PLR and CA19-9 level.

RESULTS

Based on the receiver operating characteristic analysis results, the patients were divided into PLR (PLR ≥ 129.1) and PLR (PLR < 129.1) groups and into CA19-9 (CA19-9 ≥ 74.0 U/mL) and CA19-9 (CA19-9 < 74.0 U/mL) groups. The cumulative 5-year overall survival (OS) and disease-specific survival (DSS) rates significantly differed by both the PLR (PLR group: 19.5% and 22.9%; PLR group: 39.1% and 45.9%) and CA19-9 (CA19-9 group: 19.1% and 25.6%; CA19-9 group: 41.0% and 41.0%). We then divided the patients into Groups A (PLR/CA19-9), B (PLR/CA19-9 or PLR/CA19-9), and C (PLR/CA19-9). The cumulative 5-year OS rates in Groups A, B, and C were 44.0%, 31.9%, and 11.9%, respectively (P = 0.002). The cumulative 5-year DSS rates in Groups A, B, and C were 47.7%, 36.4%, and 16.8%, respectively (P = 0.002). Multivariate analysis revealed that the combination of the PLR and CA19-9 was an independent prognostic factor in patients with resected PC.

CONCLUSIONS

The combination of the PLR and CA19-9 is useful for predicting the prognosis of patients with resected PC.