Prognostic Role of De Ritis and Basal Neutrophil to Lymphocyte Ratio in Patients With Advanced Stage Pancreatic Cancer [Izmir Oncology Group (IZOG) Study]

J BUON. Mar-Apr 2020;25(2):1063-1069.


Purpose: We aimed to investigate the prognostic significance of neutrophil/lymphocyte ratio (NLR), an indirect indicator for the immune response and AST/ALT ratio (De Ritis), liver enzymes that are commonly used in various clinical fields, in patients with advanced-stage pancreatic cancer.

Methods: NLR and De Ritis of the patients with diagnosis of locally advanced and metastatic pancreatic cancer between the 2010-2017 were evaluated retrospectively. All patients were divided into two groups as high and low according to NLR and De Ritis cut-off values which were 2.4 and 0.75, respectively.

Results: A total of 191 patients were evaluated. The mean overall survival (OS) in patients with NLR<2.4 at the time of diagnosis was 10±0.8 months, while it was 4±0.49 months in patients with NLR>2.4 (p<0.0001). The mean OS of the patients with a De Ritis <0.75 was 8±1.2 months, whereas the survival of those with De Ritis >0.75 was 6±0.74 months (p=0.024). The mean progression free survival (PFS) in patients with NLR<2.4 and De Ritis <0.75 at diagnosis were 5±0.76 months and 6±0.87 months respectively, whilst it was 3±0.37 months in patients with NLR>2.4 (p=0.017) and 4±0.3 months in patients with De Ritis >0.75 (p=0.14).

Conclusions: The NLR and De Ritis are associated with prognosis in many cancers and have been found to be associated with survival outcome in advanced-stage pancreatic cancer patients.