Author:
Shirakawa Tsuyoshi,Makiyama Akitaka,Shimokawa Mototsugu,Otsuka Taiga,Shinohara Yudai,Koga Futa,Ueda Yujiro,Nakazawa Junichi,Otsu Satoshi,Komori Azusa,Arima Shiho,Fukahori Masaru,Taguchi Hiroki,Honda Takuya,Shibuki Taro,Nio Kenta,Ide Yasushi,Ureshino Norio,Mizuta Toshihiko,Mitsugi Kenji,Akashi Koichi,Baba Eishi
Abstract
AbstractThere are limited absolute biomarkers for determining the prognosis before first- and second-line palliative chemotherapy in unresectable pancreatic cancer (urPC) patients. To find the best prognostic inflammatory marker, we investigated relationships between overall survival (OS) and six inflammatory markers; C-reactive protein/albumin ratio (CAR), neutrophil–lymphocyte ratio (NLR), prognostic nutrition index (PNI), platelet–lymphocyte ratio (PLR), Glasgow prognostic score (GPS), and prognostic index (PI). We examined 255 patients who received gemcitabine + nab-paclitaxel or FOLFIRINOX as first-line chemotherapy and 159 patients who subsequently underwent second-line chemotherapy. First-line patients with lower CAR had better OS compared to those with a higher CAR (hazard ratio 0.57; 95% confidential index 0.42–77; P < 0.01). Similarly, lower NLR (P = 0.01), higher PNI (P = 0.04), lower PLR (P = 0.03), GPS score of 0 (P < 0.01) and PI score of 0 (P < 0.01) were all associated with better OS. CAR demonstrated the best superiority for determining survival prognosis through the use of area under the curve of time-dependent receiver-operating characteristic curves. Furthermore, a lower CAR before second-line therapy exhibited better OS versus higher CAR (P < 0.01). Therefore, CAR might be a useful biomarker for predicting urPC patient prognosis in both first- and second-line chemotherapy.
Publisher
Springer Science and Business Media LLC
Cited by
2 articles.
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