Preoperative platelet to lymphocyte ratio predicts outcome of patients with pancreatic ductal adenocarcinoma after pancreatic resection

Surgery. 2015 Aug;158(2):360-5. doi: 10.1016/j.surg.2015.03.043. Epub 2015 May 29.


Background: Inflammation plays a crucial role in tumor growth, metastasis, and survival. The preoperative platelet-to-lymphocyte ratio (PLR) has been reported as a significant prognostic indicators in several digestive malignancies. Our objective was to evaluate whether preoperative PLR is a prognostic index in resected pancreatic ductal adenocarcinoma.

Methods: Data from 131 patients who underwent pancreatic resection for pancreatic ductal adenocarcinoma were available from a prospectively maintained database. The patients were divided into groups according to a preoperative PLR of <150 or ≥150. Survival data were analyzed.

Results: In univariate and multivariate analyses, a preoperative PLR of ≥150 was a significant and independent risk factor for cancer recurrence and poor survival, respectively (disease-free survival [DFS]; P= .0014, P = .047; OS, P ≤ .01each). Similarly, lymph node metastasis, and moderate or poor differentiation were independent risk factors for cancer recurrence, whereas tumor diameter, positive surgical margin, and moderate or poor differentiation were independent risk factors for poor patient survival (P ≤ .05 each).

Conclusion: The preoperative PLR in patients with pancreatic ductal adenocarcinoma was an independent predictor in DFS and overall survival after elective resection. Measurement of the PLR may help decision making in the postoperative management of patients with pancreatic ductal adenocarcinoma.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Carcinoma, Pancreatic Ductal / blood*
  • Carcinoma, Pancreatic Ductal / mortality
  • Carcinoma, Pancreatic Ductal / surgery
  • Elective Surgical Procedures
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology
  • Pancreatectomy*
  • Pancreatic Neoplasms / blood*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy*
  • Platelet Count
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome