Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients
<i>Background</i>: In many malignancies, including pancreatic ductal adenocarcinoma (PDAC), host-related inflammatory/immunonutritional markers, such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and C-reactive protein (CRP)/albumin ratio are report...
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| Format: | Article |
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MDPI AG
2019-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/11/4/514 |
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| author | Ken Ichikawa Shugo Mizuno Aoi Hayasaki Masashi Kishiwada Takehiro Fujii Yusuke Iizawa Hiroyuki Kato Akihiro Tanemura Yasuhiro Murata Yoshinori Azumi Naohisa Kuriyama Masanobu Usui Hiroyuki Sakurai Shuji Isaji |
| author_facet | Ken Ichikawa Shugo Mizuno Aoi Hayasaki Masashi Kishiwada Takehiro Fujii Yusuke Iizawa Hiroyuki Kato Akihiro Tanemura Yasuhiro Murata Yoshinori Azumi Naohisa Kuriyama Masanobu Usui Hiroyuki Sakurai Shuji Isaji |
| author_sort | Ken Ichikawa |
| collection | DOAJ |
| description | <i>Background</i>: In many malignancies, including pancreatic ductal adenocarcinoma (PDAC), host-related inflammatory/immunonutritional markers, such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and C-reactive protein (CRP)/albumin ratio are reported to be prognostic factors. However, the prognostic influence of these factors before and after chemoradiotherapy (CRT) has not been studied in PDAC patients. <i>Methods:</i> Of 261 consecutive PDAC patients who were scheduled for CRT with gemcitabine or S1 plus gemcitabine between February 2005 and December 2015, participants in this study were 176 who completed CRT and had full data available on inflammatory/immunonutritional markers as well as on anatomical and biological factors for the investigation of prognostic/predictive factors. <i>Results</i>: In multivariate analysis, the significant prognostic factors were RECIST classification, cT category, performance status, post-CRT carcinoembryonic antigen, post-CRT C-reactive protein/albumin ratio, post-CRT mGPS, and post-CRT PNI. Post-CRT PNI (cut-off value, 39) was the strongest host-related prognostic factor according to the <i>p</i>-value. In the patients who underwent resection after CRT, median survival time (MST) was significantly shorter in the 12 patients with low PNI (<39) than in the 97 with high PNI (≥39), at 15.5 months versus 27.2 months, respectively (<i>p</i> = 0.0016). In the patients who did not undergo resection, MST was only 8.9 months in those with low PNI and 12.3 months in those with high PNI (<i>p</i> < 0.0001), and thus was similar to that of the resected patients with low PNI. <i>Conclusions</i>: Post-CRT PNI was the strongest prognostic/predictive indicator among the independent biological and conditional prognostic factors in PDAC patients who underwent CRT. |
| first_indexed | 2024-03-12T06:34:22Z |
| format | Article |
| id | doaj.art-a4c272decda84dbcbdf52f67ed9cc474 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T06:34:22Z |
| publishDate | 2019-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-a4c272decda84dbcbdf52f67ed9cc4742023-09-03T01:24:40ZengMDPI AGCancers2072-66942019-04-0111451410.3390/cancers11040514cancers11040514Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma PatientsKen Ichikawa0Shugo Mizuno1Aoi Hayasaki2Masashi Kishiwada3Takehiro Fujii4Yusuke Iizawa5Hiroyuki Kato6Akihiro Tanemura7Yasuhiro Murata8Yoshinori Azumi9Naohisa Kuriyama10Masanobu Usui11Hiroyuki Sakurai12Shuji Isaji13Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, JapanHepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan<i>Background</i>: In many malignancies, including pancreatic ductal adenocarcinoma (PDAC), host-related inflammatory/immunonutritional markers, such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and C-reactive protein (CRP)/albumin ratio are reported to be prognostic factors. However, the prognostic influence of these factors before and after chemoradiotherapy (CRT) has not been studied in PDAC patients. <i>Methods:</i> Of 261 consecutive PDAC patients who were scheduled for CRT with gemcitabine or S1 plus gemcitabine between February 2005 and December 2015, participants in this study were 176 who completed CRT and had full data available on inflammatory/immunonutritional markers as well as on anatomical and biological factors for the investigation of prognostic/predictive factors. <i>Results</i>: In multivariate analysis, the significant prognostic factors were RECIST classification, cT category, performance status, post-CRT carcinoembryonic antigen, post-CRT C-reactive protein/albumin ratio, post-CRT mGPS, and post-CRT PNI. Post-CRT PNI (cut-off value, 39) was the strongest host-related prognostic factor according to the <i>p</i>-value. In the patients who underwent resection after CRT, median survival time (MST) was significantly shorter in the 12 patients with low PNI (<39) than in the 97 with high PNI (≥39), at 15.5 months versus 27.2 months, respectively (<i>p</i> = 0.0016). In the patients who did not undergo resection, MST was only 8.9 months in those with low PNI and 12.3 months in those with high PNI (<i>p</i> < 0.0001), and thus was similar to that of the resected patients with low PNI. <i>Conclusions</i>: Post-CRT PNI was the strongest prognostic/predictive indicator among the independent biological and conditional prognostic factors in PDAC patients who underwent CRT.https://www.mdpi.com/2072-6694/11/4/514chemoradiation therapypancreatic ductal adenocarcinomalocally advanced PDACPNIimmunonutritional/inflammatory markers |
| spellingShingle | Ken Ichikawa Shugo Mizuno Aoi Hayasaki Masashi Kishiwada Takehiro Fujii Yusuke Iizawa Hiroyuki Kato Akihiro Tanemura Yasuhiro Murata Yoshinori Azumi Naohisa Kuriyama Masanobu Usui Hiroyuki Sakurai Shuji Isaji Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients Cancers chemoradiation therapy pancreatic ductal adenocarcinoma locally advanced PDAC PNI immunonutritional/inflammatory markers |
| title | Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients |
| title_full | Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients |
| title_fullStr | Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients |
| title_full_unstemmed | Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients |
| title_short | Prognostic Nutritional Index after Chemoradiotherapy Was the Strongest Prognostic Predictor among Biological and Conditional Factors in Localized Pancreatic Ductal Adenocarcinoma Patients |
| title_sort | prognostic nutritional index after chemoradiotherapy was the strongest prognostic predictor among biological and conditional factors in localized pancreatic ductal adenocarcinoma patients |
| topic | chemoradiation therapy pancreatic ductal adenocarcinoma locally advanced PDAC PNI immunonutritional/inflammatory markers |
| url | https://www.mdpi.com/2072-6694/11/4/514 |
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