J Cancer 2019; 10(26):6673-6680. doi:10.7150/jca.30561

Research Paper

A Systematic Inflammation-based Model in Advanced Pancreatic Ductal Adenocarcinoma

Li-Xia Wu1,2*, Xiao-Yong Wang3*, Ke-Qun Xu4*, Yu-Li Lin5, Wen-Yu Zhu4, Long Han4, Yue-Ting Shao4, Han-Yu Zhou4, Hua Jiang4, Jun-Jie Hang4✉, Xu-Guang Yang1,6✉

1. Department of Oncology, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Pujian Road 160, Shanghai 200127, China
2. Department of Oncology, Shanghai JingAn District ZhaBei Central Hospital, Zhonghuaxin Road 619, Shanghai 200040, China
3. Department of Gastroenterology, Changzhou No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Xinglong Road 29, Changzhou, Jiangsu 213003, China
4. Department of Oncology, Changzhou No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Xinglong Road 29, Changzhou, Jiangsu 213003, China
5. Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai 200030, China
6. Cancer Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, South Wanping Road 725, Shanghai 200000, China
*Contributed equally

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Citation:
Wu LX, Wang XY, Xu KQ, Lin YL, Zhu WY, Han L, Shao YT, Zhou HY, Jiang H, Hang JJ, Yang XG. A Systematic Inflammation-based Model in Advanced Pancreatic Ductal Adenocarcinoma. J Cancer 2019; 10(26):6673-6680. doi:10.7150/jca.30561. Available from http://www.jcancer.org/v10p6673.htm

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Abstract

Emerging evidence revealed the critical role of systematic inflammation in pancreatic ductal adenocarcinoma (PDAC). In the present study, we reviewed the records of 279 patients with advanced PDAC. Among them, 147 cases were used as the training cohort and another 132 as the validation cohort. In the training cohort, distant metastasis, carbohydrate antigen 19-9 (CA19-9), Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) were independent prognostic factors in Cox regression. A nomogram based on these factors was generated to predict median survival time and survival probabilities at 6, 12, and 18 months. The nomogram showed a better discriminatory ability than the American Joint Committee on Cancer (AJCC) TNM staging (C-index: 0.727 vs. 0.610). In the validation cohort, a nomogram composed of the same variables also showed a high discriminatory ability (C-index: 0.784). In the low-risk group with a nomogram total point (NTP) value of more than 175, patients receiving combination therapy showed better prognosis than those receiving monotherapy (P=0.015). In conclusion, the nomogram based on inflammatory biomarkers can serve as useful prognostic tool for advanced PDAC. In addition, patients with high NTP can greater benefit from combination chemotherapy than monotherapy.

Keywords: pancreatic ductal adenocarcinoma, inflammatory biomarkers, nomogram, prognosis