71.01 Preoperative Platelet to Albumin Ratio is a Prognostic Factor for Pancreatic Cancer.

Posted on January 18, 2016

Y. Shirai1, H. Shiba1, N. Saito1, T. Horiuchi1, K. Haruki1, Y. Nakaseko1, Y. Takano1, K. Furukawa1, M. Kanehira1, S. Onda1, T. Sakamoto1, T. Gocho1, Y. Ishida1, K. Yanaga1 1The Jikei University School Of Medicine,Surgery,Minato-ku, TOKYO, Japan

Introduction:
Pancreatic cancer is one of the most aggressive digestive cancers. Because pancreatic cancer recurs after pancreatic resection in as many as 70-80%, it is important to predict tumor recurrence and prognosis in regard to decision making of additional adjuvant therapy. There are several inflammation based prognostic index such as Glasgow prognostic score (GPS), mGPS, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, CRP/Albumin, and prognostic nutrition index. However, preoperative estimation of oncological prognosis remains to be established. The aim of this study is to evaluate the prognostic value of preoperative platelet to albumin ratio (PAR) in pancreatic ductal adenocarcinoma after pancreatic resection.

Methods:
A total of 115 patients who underwent pancreatic resection for pancreatic invasive ductal adenocarcinoma were available from prospectively maintained database. The patients were divided into two groups as PAR ≥ 53.1 x 103 or < 53.1 x 103 on the basis of ROC curve analysis (2 years survival, AUC=0.640, p=0.011). Survival data were analyzed using the Log-rank test for univariate analysis and Cox proportional hazards for multivariate analysis. P value <0.05 was judged as significant.

Results:
The preoperative PAR was significant prognostic index on univariate analysis for disease-free and overall survivals. The median overall survival in patients with PAR ≥ 53.1 x 103 was 17.6 months, which was poorer than 36.1 months for patients with PAR < 53.1 x 103 (p=0.0039). The PAR retained its significance on multivariate analysis for overall survival (HR 1.666, 95%CI 1.021-2.717, p=0.041) along with tumor stage (p=0.047) and serum CA19-9 (p=0.010). PAR ≥ 53.1 x 103 was also a significant independent prognostic index for poor disease-free survival on multivariate analysis (HR 1.771, 95%CI 1.055-2.973, p=0.031).

Conclusion:
The preoperative PAR is a novel significant independent prognostic index for disease-free and overall survival in resected pancreatic invasive ductal adenocarcinoma.