Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma

Am J Surg. 2009 Apr;197(4):466-72. doi: 10.1016/j.amjsurg.2007.12.057. Epub 2008 Jul 17.


Background: The objective of this study was to investigate whether the preoperative platelet-lymphocyte (P/L) ratio represents a significant prognostic index in resected pancreatic ductal adenocarcinoma.

Methods: A total of 110 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a prospectively maintained database.

Results: The preoperative P/L ratio was found to be a more significant prognostic marker (P < .001) than either the lymphocyte count (P = .007) or platelet count (P = .068) on univariate Cox survival analysis. The median overall survival in patients with a P/L ratio of 150 or less (n = 48) was 19.7 months, 13.7 months in those with a P/L ratio of 151 to 300 (n = 43), and 5.8 months in patients with a value of greater than 300 (n = 19) (log-rank, P = .006). The preoperative P/L ratio retained significance on multivariate analysis (P < .001), along with tumor size (P = .010) and lymph node ratio (P = .013).

Conclusions: The preoperative P/L ratio represents a significant independent prognostic index in patients of resected pancreatic adenocarcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Carcinoma, Pancreatic Ductal / blood
  • Carcinoma, Pancreatic Ductal / surgery*
  • Female
  • Humans
  • Lymphocyte Count*
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / blood
  • Pancreatic Neoplasms / surgery*
  • Platelet Count*
  • Predictive Value of Tests
  • Preoperative Care
  • Prognosis


  • Biomarkers