PMID- 24075520
OWN - NLM
STAT- MEDLINE
DCOM- 20140505
LR  - 20240102
IS  - 1424-3911 (Electronic)
IS  - 1424-3903 (Linking)
VI  - 13
IP  - 5
DP  - 2013 Sep-Oct
TI  - Elevated pre-operative neutrophil to lymphocyte ratio predicts disease free 
      survival following pancreatic resection for periampullary carcinomas.
PG  - 534-8
LID - S1424-3903(13)00761-8 [pii]
LID - 10.1016/j.pan.2013.07.283 [doi]
AB  - BACKGROUND: The pre-operative neutrophil-to-lymphocyte ratio (NLR), when >/=5 has 
      been associated with reduced survival for patients with various gastrointestinal 
      tract cancers, however, it's prognostic value in patients with periampullary 
      tumour has not been reported to date. OBJECTIVES: To determine the prognostic 
      value of pre-operative NLR in terms of survival and recurrence of resected 
      periampullary carcinomas. METHODS: This was a retrospective cohort study of 
      consecutive patients undergoing pancreatoduodenectomy (PD) for periampullary 
      carcinoma (pancreatic, ampullary, cholangiocarcinoma) identified from a 
      departmental database. The effect of NLR upon survival and recurrence was 
      explored. RESULTS: Overall median survival amongst 228 patients was 24 months 
      (inter-quartile range [IQR]: 12-43). The median survival for those whose NLR was 
      <5 was not significantly greater than those patients whose NLR was >/=5 (24 months 
      [IQR: 14-42] versus 13 months [IQR: 8-48], respectively; p = 0.234). However, for 
      those that developed recurrence, survival was greater in those with an NLR <5 at 
      (20 months [IQR: 12-27] versus 11 months [IQR: 7-22], respectively; p = 0.038). 
      This effect was most marked in those patients with cholangiocarcinoma (p = 0.019) 
      whilst a trend to worse survival was seen in those with pancreatic 
      adenocarcinoma. No effect was seen in patients with ampullary carcinoma 
      (p = 0.516). CONCLUSIONS: This study provides further evidence that pre-operative 
      NLR offers important prognostic information regarding disease-free survival. This 
      effect, however, is dependent upon the tumour type amongst patients undergoing 
      PD.
CI  - Copyright (c) 2013 IAP and EPC. Published by Elsevier B.V. All rights reserved.
FAU - Hamed, Mazin O
AU  - Hamed MO
AD  - The Pancreatic Unit, St James's University Hospital, Beckett Street, Leeds LS9 
      7TF, UK.
FAU - Roberts, Keith J
AU  - Roberts KJ
FAU - Smith, Andrew M
AU  - Smith AM
FAU - Morris Stiff, Gareth
AU  - Morris Stiff G
LA  - eng
PT  - Journal Article
DEP - 20130731
PL  - Switzerland
TA  - Pancreatology
JT  - Pancreatology : official journal of the International Association of 
      Pancreatology (IAP) ... [et al.]
JID - 100966936
SB  - IM
MH  - Adenocarcinoma/mortality/surgery
MH  - Aged
MH  - Cholangiocarcinoma/mortality
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - *Lymphocyte Count
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/mortality
MH  - Neutrophils/*pathology
MH  - Pancreatic Neoplasms/*mortality/surgery
MH  - *Pancreaticoduodenectomy
MH  - Prognosis
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Disease-free survival
OT  - Neutrophil-lymphocyte ratio
OT  - Pancreatoduodenectomy
OT  - Periampullary carcinoma
EDAT- 2013/10/01 06:00
MHDA- 2014/05/06 06:00
CRDT- 2013/10/01 06:00
PHST- 2013/03/06 00:00 [received]
PHST- 2013/05/16 00:00 [revised]
PHST- 2013/07/23 00:00 [accepted]
PHST- 2013/10/01 06:00 [entrez]
PHST- 2013/10/01 06:00 [pubmed]
PHST- 2014/05/06 06:00 [medline]
AID - S1424-3903(13)00761-8 [pii]
AID - 10.1016/j.pan.2013.07.283 [doi]
PST - ppublish
SO  - Pancreatology. 2013 Sep-Oct;13(5):534-8. doi: 10.1016/j.pan.2013.07.283. Epub 
      2013 Jul 31.