TY - JOUR
T1 - Prognostic significance of preoperative PNI and CA19-9 for pancreatic ductal adenocarcinoma
T2 - A multi-institutional retrospective study
AU - Itoh, Shinji
AU - Tsujita, Eiji
AU - Fukuzawa, Kengo
AU - Sugimachi, Keishi
AU - Iguchi, Tomohiri
AU - Ninomiya, Mizuki
AU - Maeda, Takashi
AU - Kajiyama, Kiyashi
AU - Adachi, Eisuke
AU - Uchiyama, Hideaki
AU - Utsunomiya, Tohru
AU - Ikeda, Yasuharu
AU - Maekawa, Soichirou
AU - Toshima, Takeo
AU - Harada, Noboru
AU - Yoshizumi, Tomoharu
AU - Mori, Masaki
N1 - Funding Information:
The authors have no conflicts of interest to declare. This study was supported by the following grants: JSPS KAKENHI, Grants-in-Aid from the Ministry of Health, Labour and Welfare, Japan (Numbers JP-15H05791 and JP-19K09198 ). The funding sources had no role in the collection, analysis, or interpretation of the data, or in the decision to submit the article for publication.
Publisher Copyright:
© 2021 The Authors
PY - 2021/10
Y1 - 2021/10
N2 - Background: The aim of this study was to investigate the clinical value of nutritional and immunological prognostic scores as predictors of outcomes and to identify the most promising scoring system for patients with pancreatic ductal adenocarcinoma (PDAC) in a multi-institutional study. Methods: Data were retrospectively collected for 589 patients who underwent surgical resection for PDAC. Prognostic analyses were performed for overall (OS) and recurrence-free survival (RFS) using tumor and patient-related factors, namely neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, Prognostic Nutritional Index (PNI), Glasgow Prognostic Score (GPS), modified GPS, C-reactive protein-to-albumin ratio, Controlling Nutritional Status score, and the Geriatric Nutritional Risk Index. Results: Compared with PDAC patients with high PNI values (≥46), low PNI (<46) patients showed significantly worse overall survival (OS) (multivariate hazard ratio (HR), 1.432; 95% CI, 1.069–1.918; p = 0.0161) and RFS (multivariate HR, 1.339; 95% CI, 1.032–1.736; p = 0.0277). High carbohydrate antigen 19–9 (CA19-9) values (≥450) were significantly correlated with shorter OS (multivariate HR, 1.520; 95% CI, 1.261–2.080; p = 0.0002) and RFS (multivariate HR, 1.533; 95% CI, 1.199–1.961; p = 0.0007). Stratification according to PNI and CA19-9 was also significantly associated with OS and RFS (log rank, P < 0.0001). Conclusions: Our large cohort study showed that PNI and CA19-9 were associated with poor clinical outcomes in PDAC patients following surgical resection. Additionally, combining PNI with CA19-9 enabled further classification of patients according to their clinical outcomes.
AB - Background: The aim of this study was to investigate the clinical value of nutritional and immunological prognostic scores as predictors of outcomes and to identify the most promising scoring system for patients with pancreatic ductal adenocarcinoma (PDAC) in a multi-institutional study. Methods: Data were retrospectively collected for 589 patients who underwent surgical resection for PDAC. Prognostic analyses were performed for overall (OS) and recurrence-free survival (RFS) using tumor and patient-related factors, namely neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, Prognostic Nutritional Index (PNI), Glasgow Prognostic Score (GPS), modified GPS, C-reactive protein-to-albumin ratio, Controlling Nutritional Status score, and the Geriatric Nutritional Risk Index. Results: Compared with PDAC patients with high PNI values (≥46), low PNI (<46) patients showed significantly worse overall survival (OS) (multivariate hazard ratio (HR), 1.432; 95% CI, 1.069–1.918; p = 0.0161) and RFS (multivariate HR, 1.339; 95% CI, 1.032–1.736; p = 0.0277). High carbohydrate antigen 19–9 (CA19-9) values (≥450) were significantly correlated with shorter OS (multivariate HR, 1.520; 95% CI, 1.261–2.080; p = 0.0002) and RFS (multivariate HR, 1.533; 95% CI, 1.199–1.961; p = 0.0007). Stratification according to PNI and CA19-9 was also significantly associated with OS and RFS (log rank, P < 0.0001). Conclusions: Our large cohort study showed that PNI and CA19-9 were associated with poor clinical outcomes in PDAC patients following surgical resection. Additionally, combining PNI with CA19-9 enabled further classification of patients according to their clinical outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85113320658&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85113320658&partnerID=8YFLogxK
U2 - 10.1016/j.pan.2021.08.003
DO - 10.1016/j.pan.2021.08.003
M3 - Article
C2 - 34426076
AN - SCOPUS:85113320658
SN - 1424-3903
VL - 21
SP - 1356
EP - 1363
JO - Pancreatology
JF - Pancreatology
IS - 7
ER -
