Systemic Inflammatory Response and Elevated Tumour Markers Predict Worse Survival in Resectable Pancreatic Ductal Adenocarcinoma

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Salmiheimo , A , Mustonen , H , Stenman , U-H , Puolakkainen , P , Kemppainen , E , Seppanen , H & Haglund , C 2016 , ' Systemic Inflammatory Response and Elevated Tumour Markers Predict Worse Survival in Resectable Pancreatic Ductal Adenocarcinoma ' PLoS One , vol. 11 , no. 9 , 0163064 . DOI: 10.1371/journal.pone.0163064

Title: Systemic Inflammatory Response and Elevated Tumour Markers Predict Worse Survival in Resectable Pancreatic Ductal Adenocarcinoma
Author: Salmiheimo, Aino; Mustonen, Harri; Stenman, Ulf-Hakan; Puolakkainen, Pauli; Kemppainen, Esko; Seppanen, Hanna; Haglund, Caj
Contributor: University of Helsinki, Department of Surgery
University of Helsinki, Department of Clinical Chemistry and Hematology
University of Helsinki, Department of Surgery
University of Helsinki, II kirurgian klinikka
University of Helsinki, Department of Surgery
University of Helsinki, Department of Surgery
Date: 2016-09-15
Language: eng
Number of pages: 14
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/169013
Abstract: Background Estimation of the prognosis of resectable pancreatic ductal adenocarcinoma (PDAC) currently relies on tumour-related factors such as resection margins and on lymph-node ratio (LNR) both inconveniently available only postoperatively. Our aim was to assess the accuracy of preoperative laboratory data in predicting PDAC prognosis. Methods Collection of laboratory and clinical data was retrospective from 265 consecutive patients undergoing surgery for PDAC at Helsinki University Hospital. Cancer-specific survival assessment utilized Kaplan-Meier analysis, and independent associations between factors were by the Cox regression model. Results During follow-up, 76% of the patients died of PDAC, with a median survival time of 19.6 months. In univariate analysis, CRP, albumin, CEA, and CA19-9 were significantly associated with postoperative cancer-specific survival. In multivariate analysis, taking into account age, gender, LNR, resection margins, tumour status, and adjuvant chemotherapy, the preoperative biomarkers independently associated with adverse prognosis were hypoalbuminemia (<36 g/L, hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.10-2.19, p = 0.011), elevated CRP (> 5 mg/L, HR 1.44, 95% CI 1.03-2.02, p = 0.036), CEA (> 5 mu g/L, HR 1.60, 95% CI 1.07-2.53, p = 0.047), and CA19-9 (>= 555 kU/L, HR 1.91, 95% CI 1.18-3.08, p = 0.008). Conclusion For patients with resectable PDAC, preoperative CRP, along with albumin and tumour markers, is useful for predicting prognosis.
Subject: C-REACTIVE PROTEIN
NEUTROPHIL-LYMPHOCYTE RATIO
PROGNOSTIC SCORE
CANCER
SERUM
MECHANISMS
CARCINOMA
RESECTION
PARADIGM
BIOLOGY
3126 Surgery, anesthesiology, intensive care, radiology
3122 Cancers
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