Effects of Preoperative Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios on Survival in Patients with Extrahepatic Cholangiocarcinoma.

As indicators of systemic inflammatory response, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) predict prognoses for various cancers. This study investigated their prognostic significance in extrahepatic cholangiocarcinoma (ECC). We analyzed 120 patients who underwent surgery for ECC between 2000 and 2014. We calculated preoperative NLR and PLR and evaluated their correlations with patients' clinicopathological features and prognosis. Although high NLR was not associated with worse recurrence-free survival (RFS) (hazard ratio (HR)=1.32, p=0.26), cancer-specific survival (CSS) (HR=1.35, p=0.31) and overall survival (OS) (HR=1.19, p=0.52), high PLR was significantly associated with worse RFS (HR=1.85, p=0.01), CSS (HR=2.38, p=0.002) and OS (HR=1.98, p=0.008). In multivariate analysis, high PLR (HR=1.89, p=0.02) and lymph node metastasis (HR=1.78, p=0.03) were independent prognostic factors for OS. A high PLR had more liver recurrences (p=0.04) and recurrences within 1 year (HR=2.38, p=0.02) than low PLR. High preoperative PLR was an independent predictor of poor prognosis for patients with ECC who underwent resections.

Kitano Y ，Yamashita YI ，Yamamura K ，Arima K ，Kaida T ，Miyata T ，Nakagawa S ，Mima K ，Imai K ，Hashimoto D ，Chikamoto A ，Baba H ... -  《-》

Elevated NLR in gallbladder cancer and cholangiocarcinoma - making bad cancers even worse: results from the US Extrahepatic Biliary Malignancy Consortium.

Gallbladder and extrahepatic biliary malignancies are aggressive tumors with high risk of recurrence and death. We hypothesize that elevated preoperative Neutrophil-Lymphocyte Ratios (NLR) are associated with poor prognosis among patients undergoing resection of gallbladder or extrahepatic biliary cancers. Patients who underwent complete surgical resection between 2000-2014 were identified from 10 academic centers (n=525). Overall (OS) and recurrence-free survival (RFS) were analyzed by stratifying patients with normal (<5) versus elevated (>5) NLR. Overall, 375 patients had NLR <5 while 150 patients had NLR >5. Median OS was 24.5 months among patients with NLR<5 versus 17.0 months among patients with NLR>5 (p<0.001). NLR was also associated with OS in subgroup analysis of patients with gallbladder cancer. In fact, on multivariable analysis, NLR>5, dyspnea and preoperative peak bilirubin were independently associated with OS in patients with gallbladder cancer. Median RFS was 26.8 months in patients with NLR<5 versus 22.7 months among patients with NLR>5 (p=0.030). NLR>5 was independently associated with worse RFS for patients with gallbladder cancer. Elevated NLR was associated with worse outcomes in patients with gallbladder and extrahepatic biliary cancers after curative-intent resection. NLR is easily measured and may provide important prognostic information.

Beal EW ，Wei L ，Ethun CG ，Black SM ，Dillhoff M ，Salem A ，Weber SM ，Tran T ，Poultsides G ，Son AY ，Hatzaras I ，Jin L ，Fields RC ，Buettner S ，Pawlik TM ，Scoggins C ，Martin RC ，Isom CA ，Idrees K ，Mogal HD ，Shen P ，Maithel SK ，Schmidt CR ... -  《-》

Negative impact of preoperative platelet-lymphocyte ratio on outcome after hepatic resection for intrahepatic cholangiocarcinoma.

Chen Q ，Dai Z ，Yin D ，Yang LX ，Wang Z ，Xiao YS ，Fan J ，Zhou J ... -  《-》

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma.

Several preoperative systemic inflammatory parameters, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and Glasgow Prognostic Score, have been reported to be associated with the prognosis of solid tumors. However, there are conflicting survival data regarding these parameters in cholangiocarcinoma. In this study, we performed a retrospective cohort analysis of patients with distal cholangiocarcinoma (DCC) who underwent surgical resection to evaluate the prognostic value of a cluster of preoperative hematological inflammatory parameters for survival. Fifty-three patients with DCC who underwent pancreaticoduodenectomy with curative intent were enrolled. The optimal cutoff values of hematological inflammatory parameters, including the absolute lym-phocyte count, NLR, PLR, and LMR, were determined by time-dependent receiver operating characteristic analysis. -Results: The univariate analysis for overall survival (OS) of conventional factors and hematological inflammatory parameters identified that portal vein invasion and PLR had p values of ≤0.1. The univariate analysis for disease-free survival (DFS) identified that lymph node metastasis, PLR, lymphocyte count, and number of positive lymph nodes (≥3) had p values of ≤0.1. These factors were incorporated into the full model and variables were selected using the backward stepwise method. The multivariate analysis identified portal vein invasion and high PLR as independent prognostic factors for OS (p = 0.033 and 0.039, respectively) and high PLR and number of positive lymph nodes (≥3) as independent prognostic factors for DFS (p = 0.016 and 0.004, respectively). Preoperative PLR assessment may be useful for detecting high-risk DCC patients undergoing surgical resection for aggressive adjuvant therapy.

Hoshimoto S ，Hishinuma S ，Shirakawa H ，Tomikawa M ，Ozawa I ，Ogata Y ... -  《-》

Are neutrophil/lymphocyte ratio and platelet/lymphocyte ratio associated with prognosis in patients with HER2-positive early breast cancer receiving adjuvant trastuzumab?

Ulas A ，Avci N ，Kos T ，Cubukcu E ，Olmez OF ，Bulut N ，Degirmenci M ... -  《Journal of BUON》