Int J Med Sci 2020; 17(10):1449-1457. doi:10.7150/ijms.46254

Research Paper

Pretreatment biomarkers as prognostic predictors of survival in patients with Pancreatic Cancer treated with Gemcitabine-based Therapy and 5-Fluorouracil: Neutrophil-to-lymphocyte ratio vs Platelet-to-lymphocyte ratio

Yungu Chen1#, Yuan Liao2#, Lek Man Lam3, Lina He3, Yiu Sing Tsang3, Ying-San Di4, Sheng-Tao Liang4, Qing Xia1✉

1. Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, 200127, China.
2. Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
3. Department of Basic Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
4. Department of Oncology, Baoshan Branch Hospital, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200436, China.
#These authors contributed equally to this work.

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Citation:
Chen Y, Liao Y, Lam LM, He L, Tsang YS, Di YS, Liang ST, Xia Q. Pretreatment biomarkers as prognostic predictors of survival in patients with Pancreatic Cancer treated with Gemcitabine-based Therapy and 5-Fluorouracil: Neutrophil-to-lymphocyte ratio vs Platelet-to-lymphocyte ratio. Int J Med Sci 2020; 17(10):1449-1457. doi:10.7150/ijms.46254. Available from http://www.medsci.org/v17p1449.htm

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Abstract

Although elevated neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been reported to be inverse prognostic predictors of survival in patients with pancreatic cancer (PC), the comparison of their prognostic roles in patients with PC undergoing gemcitabine-based chemotherapy and 5-fluorouracil (5-FU) remains unclear. This study was designed and performed to determine the predictive roles of NLR and PLR in patients diagnosed with PC who underwent one of these two regimens. We retrospectively enrolled 95 patients diagnosed with PC undergoing supportive care, gemcitabine-based chemotherapy or 5-FU therapy from January 2015 to October 2018. Univariate and multivariate Cox regression analyses were done to identify clinicopathological predictors of time to treatment failure (TTF) and overall survival (OS), including pretreatment NLR and PLR. The statistical data showed that pretreatment NLR was significantly associated with metastasis. Among all analyzed variables, pretreatment NLR was an independent prognostic predictor of both TTF and OS of patients with PC, with NLR>4.0 predicting worse survival. PLR, however, didn't independently predict TTF or OS. There were no significant difference in the OS of patients undergoing gemcitabine-based regimens and 5-FU regimens when divided into two subgroups: NLR ≤4.0 and >4.0. In conclusion, pretreatment NLR is a promising independent outcome predictor for patients with PC, while NLR might not be a suitable factor in the selection of regimens for patients with PC.

Keywords: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, pancreatic cancer, prognosis, gemcitabine, 5-fluorouracil