The Systemic-immune-inflammation Index Independently Predicts Survival and Recurrence in Resectable Pancreatic Cancer and its Prognostic Value Depends on Bilirubin Levels: A Retrospective Multicenter Cohort Study
| العنوان: | The Systemic-immune-inflammation Index Independently Predicts Survival and Recurrence in Resectable Pancreatic Cancer and its Prognostic Value Depends on Bilirubin Levels: A Retrospective Multicenter Cohort Study |
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| المؤلفون: | Mustafa Suker, Bas Groot Koerkamp, Casper H.J. van Eijck, Yarne Klaver, Kostandinos Sideras, N. A. Aziz, Roel Haen, Daphne Roos, Bert A. Bonsing, Mohammad Hosein Aziz, J.S.D. Mieog, Katya Mauff, Erwin van der Harst, Lawlaw Saida |
| المساهمون: | Surgery, Epidemiology, Medical Oncology |
| المصدر: | Annals of Surgery Annals of Surgery, 270(1), 139-146. LIPPINCOTT WILLIAMS & WILKINS Annals of Surgery, 270(1), 139-146. Lippincott Williams & Wilkins |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | 0301 basic medicine, Adult, Male, medicine.medical_specialty, medicine.medical_treatment, pancreatic cancer, pancreatic ductal adenocarcinoma, prognostic biomarkers, survival, Gastroenterology, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Pancreatectomy, SDG 3 - Good Health and Well-being, Internal medicine, Pancreatic cancer, medicine, Carcinoma, Biomarkers, Tumor, Humans, Prospective cohort study, Lymph node, Aged, Retrospective Studies, Aged, 80 and over, Inflammation, systemic-immune-inflammation-index, business.industry, Hazard ratio, Reproducibility of Results, Retrospective cohort study, Bilirubin, Middle Aged, medicine.disease, Prognosis, Pancreatic Neoplasms, 030104 developmental biology, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Surgery, Female, Neoplasm Recurrence, Local, business, obstructive jaundice, Cohort study, Carcinoma, Pancreatic Ductal, Follow-Up Studies |
| الوصف: | Objective: Our aim was to determine the prognostic significance of the systemic-immune-inflammation index (SIII) in patients with resectable pancreatic cancer, using cancer-specific survival as the primary outcome.Background: Pancreatic cancer is associated with a dysfunctional immune system and poor prognosis. We examined the prognostic significance of the SIII in patients with resectable pancreatic ductal adenocarcinoma (PDAC) and the effects of bilirubin on this index.Methods: We retrospectively assessed all pancreatic resections performed between 2004 and 2015 at 4 tertiary referral centers to identify pathologically confirmed PDAC patients. Baseline clinicopathologic characteristics, preoperative laboratory values such as absolute neutrophil, lymphocyte, and platelet counts, C-reactive protein, albumin, bilirubin, and CA19-9 levels, and also follow-up information, were collected. The associations of the calculated inflammatory indices with outcome were both internally and externally validated.Results: In all, 590 patients with resectable PDAC were included. The discovery and validation cohort included 170 and 420 patients, respectively. SIII > 900 [hazard ratio (HR) 2.32, 95% confidence interval (CI) 1.55-3.48], lymph node ratio (HR 3.75, 95% CI 2.08-6.76), and CA19.9 > 200 kU/L (HR 1.62, 95% CI 1.07-2.46) were identified as independent predictors of cancer-specific survival. Separate model analysis confirmed that preoperative SIII contributed significantly to prognostication. However, SIII appeared to lose its prognostic significance in patients with bilirubin levels above 200 mu mol/L.Conclusions: SIII is an independent predictor of cancer-specific survival and recurrence in patients with resectable PDAC. SIII may lose its prognostic significance in patients with high bilirubin levels. Properly designed prospective studies are needed to further confirm this hypothesis. |
| تدمد: | 1528-1140 0003-4932 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e1910e0c01b3fb60e26154be57258f81Test https://pubmed.ncbi.nlm.nih.gov/29334554Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....e1910e0c01b3fb60e26154be57258f81 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15281140 00034932 |
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