ArticleSurgery2016
Increased neutrophil-to-lymphocyte ratio after neoadjuvant therapy is associated with worse survival after resection of borderline resectable pancreatic ductal adenocarcinoma.
Article in Surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Prognostic value of lymphocyte to monocyte ratio in pancreatic cancer: a systematic review and meta-analysis including 3338 patients.World journal of surgical oncology · 2020Pooled it
- The pretreatment lymphocyte to monocyte ratio predicts clinical outcome for patients with hepatocellular carcinoma: A meta-analysis.Scientific reports · 2017Pooled it
- Prognostic value of the lymphocyte monocyte ratio in patients with colorectal cancer: A meta-analysis.Medicine · 2016Pooled it
- Chemotherapy-Induced Reduction of Neutrophil-to-Lymphocyte Ratio Is Associated With Better Survival in Pancreatic Adenocarcinoma: A Meta-Analysis.Cancer control : journal of the Moffitt Cancer CenterPooled it
- Conversion surgery for unresectable pancreatic ductal adenocarcinoma with liver metastasis at initial diagnosis: a nationwide multicenter study.Journal of gastroenterology · 2026Article
- Clinical Value of Mean Platelet Volume to Platelet Ratio (MPR) in Distinguishing Mass-Forming Chronic Pancreatitis and Pancreatic Cancer.Diagnostics (Basel, Switzerland) · 2023Article
- Scoring model with serum albumin and CA19-9 for metastatic pancreatic cancer in second-line treatment: results from the NAPOLEON study.International journal of clinical oncology · 2023Article
- Comprehensive multimodal management of borderline resectable pancreatic cancer: Current status and progress.World journal of gastrointestinal surgery · 2023Review
- Article
- Nutritional impact of active hexose-correlated compound for patients with resectable or borderline-resectable pancreatic cancer treated with neoadjuvant therapy.Surgery today · 2021Article
- Regorafenib treatment outcome for Taiwanese patients with metastatic gastrointestinal stromal tumors after failure of imatinib and sunitinib: A prospective, non-randomized, single-center study.Oncology letters · 2020Article
- Article
- Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios inversely correlate to clinical and pathologic stage in patients with resectable pancreatic ductal adenocarcinoma.Annals of pancreatic cancer · 2019Article
- TGF-β Inhibitors in Metastatic Pancreatic Ductal Adenocarcinoma.Journal of gastrointestinal cancer · 2019Review
- Neutrophil-lymphocyte ratio dynamics are useful for distinguishing between recurrence and pseudoprogression in high-grade gliomas.Cancer management and research · 2019Article
- IL23 and TGF-ß diminish macrophage associated metastasis in pancreatic carcinoma.Scientific reports · 2018Article
- Pretreatment neutrophil-to-lymphocyte ratio and its dynamic change during neoadjuvant chemotherapy as poor prognostic factors in advanced ovarian cancer.Obstetrics & gynecology science · 2018Article
- Understanding the Multifaceted Role of Neutrophils in Cancer and Autoimmune Diseases.Frontiers in immunology · 2018Review
- An Increased Neutrophil-to-Lymphocyte Ratio Predicts Incomplete Response to Therapy in Differentiated Thyroid Cancer.International journal of medical sciences · 2018Article
- Prognostic role of lymphocyte to monocyte ratio for patients with pancreatic cancer: a systematic review and meta-analysis.OncoTargets and therapy · 2017Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe neutrophil-to-lymphocyte ratio (neutrophil count divided by lymphocyte count) is a marker of inflammation associated with poor cancer outcomes. The role of neutrophil-to-lymphocyte ratio in borderline resectable pancreatic ductal adenocarcinoma is unknown. We hypothesized that increased neutrophil-to-lymphocyte ratio in patients with borderline resectable pancreatic ductal adenocarcinoma after neoadjuvant therapy is inversely associated with survival.
methodsWe used our borderline resectable pancreatic ductal adenocarcinoma database to identify patients who had completed neoadjuvant therapy and underwent resection. The neutrophil-to-lymphocyte ratio difference was calculated as the neutrophil-to-lymphocyte ratio after neoadjuvant therapy minus the neutrophil-to-lymphocyte ratio before neoadjuvant therapy. Patients were assigned to the increased neutrophil-to-lymphocyte ratio cohort if the difference was ≥2.5 units; all others were assigned to the stable neutrophil-to-lymphocyte ratio cohort. Statistical analyses were performed with t test and regression.
resultsOf 62 patients identified, 43 were assigned to the stable neutrophil-to-lymphocyte ratio cohort, and 19 to the increased neutrophil-to-lymphocyte ratio cohort. There were no differences in stage, age, or sex. The preneoadjuvant neutrophil-to-lymphocyte ratio was 3.1 ± 2.4, whereas the postneoadjuvant neutrophil-to-lymphocyte ratio was 4.4 ± 3.5 (P = .002). Overall survival was worse in the increased neutrophil-to-lymphocyte ratio cohort compared with the stable neutrophil-to-lymphocyte ratio cohort (P = .009) with a Cox hazard ratio of 2.9 (P = .02). N0 disease conferred a survival advantage over N1 disease (Cox hazard ratio = 0.3, P = .01). On multivariate Cox hazard regression analysis, both increased neutrophil-to-lymphocyte ratio and N1 stage were associated with worse survival (P < .01).
conclusionThis investigation shows an independent, inverse association between survival and decreased neutrophil-to-lymphocyte ratio in patients with borderline resectable pancreatic ductal adenocarcinoma. These findings support exploring predictive inflammatory biomarkers, such as neutrophil-to-lymphocyte ratio, to investigate inflammation and improve outcomes.
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