Abstract 5261: Prognosis of baseline absolute lymphocyte count (ALC) and neutrophil to lymphocyte ratio (NLR) in patients with pancreatic adenocarcinoma
Authors: Anand Kartik , Borazanci Erkut , Pai Sachin , Shi Runhua , Jafri Syed H. , Mills Glenn 
Published: August 2015

Introduction

There are no established prognostic biomarkers in pancreatic adenocarcinoma (PDAC). ALC and NLR have recently been of considerable interest in a variety of cancers including pancreatic cancer as a potential prognostic biomarker. In this single institution, retrospective study, we evaluated ALC and NLR as prognostic indicators for pancreatic cancer.

Methods:

We performed a retrospective chart review of patients diagnosed at LSU Health Shreveport with PDAC from Jan 1, 2000 to December 31, 2010. Various clinical, laboratory, imaging and treatment data were recorded. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count.

Results

A total of 152 patients had analyzable data. Median overall survival across all patients examined was 5.34 months. Univariate COX analysis showed hazard ratio favorable for patients with early stage pancreatic cancer, better performance status, those who received chemo-radiation and surgery, ALC ≥ 1000 and NLR &lt; 10 (table 1). Hazard ratio for NLR ≥10 vs &lt;10 was 2.575 (CI 1.50-4.39) on multivariate analysis (table 1). Median Overall Survival (OS) for subjects with NLR ≤10 = 5.65 months in comparison to 1.68 months for those with NLR over &gt;10 (P = 0.001). Median OS for subjects with ALC ≤999 = 2.47 months compared to those with ALC &gt;1000 = 6.02 months (P &lt; 0.001).

Table 1.Univariate & multivariate analysis of hazard ratios of survival with respect to various clinical characteristics in patients with pancreatic adenocarcinoma.Univariate analysisRisk factorsHRP valueStage 1 or 2 vs Stage 3 or 40.520.0035African American vs caucacian0.8660.4051Insurance vs No Insurance1.3750.1544Female vs Male1.1660.3834Bilirubin Elevated No vs Yes1.2840.1871Chemo Radiation No vs Yes2.2280.0055Surgery No vs Yes1.7770.0078Tobacco No vs Yes1.1160.6096Performance Status ≤2 vs &gt; 20.4130.0012agex ≤ 60 vs &gt;600.980.9063Absolute Lymphocyte count ≤ 999 vs &gt;9992.2240.001NlLR ≥ 10 vs &lt;102.2540.0015Multivariate analysisHRConfidence IntervalPerformance Status ≤2 vs &gt; 20.3080.173 - 0.548Stage 1 or 2 vs Stage 3 or 40.4910.272 - 0.884NlLR ≥ 10 vs &lt;102.5751.508 - 4.398CA199 ≤200 vs &gt; 2000.9880.632 - 1.544

Conclusion:

ALC and NLR are routinely performed laboratory tests which are inexpensive and have prognostic value in pancreatic cancers. The biological mechanisms underlying changes in ALC and NLR needs further exploration and could be a potential area for translational research.

Citation Format: Kartik Anand, Erkut Borazanci, Sachin Pai, Runhua Shi, Syed H. Jafri, Glenn Mills. Prognosis of baseline absolute lymphocyte count (ALC) and neutrophil to lymphocyte ratio (NLR) in patients with pancreatic adenocarcinoma. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5261. doi:10.1158/1538-7445.AM2015-5261