C0016 - Prognostic Value of Systemic Inflammatory Markers in Patients With Pancreatic Adenocarcinoma

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

OA

Osama Abu-Shawer, MD, MS

Cleveland Clinic
Cleveland, OH

Osama Abu-Shawer, MD, MS¹, Thabet Qapaja, MD¹, Motasem Alkhayyat, MD², Arjun Chatterjee, MD², Mohammed El-Dallal, MD³, Muhammad Haseeb, MD, MSc⁴
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Foundation, Cleveland, OH; ³Harvard Medical School, Cambridge, MA; ⁴Beth Israel Deaconess Medical Center, Boston, MA

Introduction: Several studies have shown the role of inflammatory markers, especially the neutrophil-to-lymphocyte Ratio (NLR), as indicators of poor prognosis in various gastrointestinal malignancies. We aimed to examine the prognostic value of NLR, among other markers, and their relationship with the presence of baseline distant metastasis in patients with pancreatic adenocarcinoma.

Methods: We retrospectively reviewed the charts of 355 patients with pancreatic cancer treated at a tertiary cancer center from 2013 to 2018. We examined the relationship between absolute eosinophilic count (AEC), absolute lymphocyte count (ALC), absolute monocytic count (AMC), absolute neutrophil count (ANC), monocyte to lymphocyte ratio (MLR), NLR, and platelet to lymphocyte ratio (PLR) with the presence distant metastases, and overall survival (OS). We used multivariable logistic regression analyses to test the association between the variables and the presence of baseline distant metastases.

Results: The median age was 60 years, and males comprised 59% of the patients. The ROC value of 3.3 was determined as the cutoff value for NLR. High NLR (NLR > 3.3 µL) was significantly associated with the presence of distant metastasis at diagnosis (p-value < 0.0001, Odds Ratio (OR): 1.7, CI: 2.6-4.0). High baseline ANC (≥5500/μL), high AMC (≥600 /μL), and high MLR (≥0.3) were also associated with baseline distant metastases (p-value: 0.02, 0.001, and < 0.0001 respectively). Multivariable analysis showed that high NLR (p-value, 0.0003, OR 2.5 95% CI 1.5-4.1) was an independent risk factor for distant metastasis at presentation. High ANC, NLR, MLR, and PLR and low ALC were associated with poor OS, (p-value: < 0.0001, < 0.0001, < 0.0001, 0.04, and 0.01, respectively).

Discussion: High systemic inflammatory markers are associated with poor prognosis (the presence of distant metastasis) and poor OS in patients with pancreatic cancer. Simple laboratory tests such as complete blood counts can be used as markers of poor prognosis and poor OS in patients with pancreatic cancer.

Figure: Figure-1; Kaplan Meier curve for overall survival with NLR
Figure-2; Kaplan Meier curve for overall survival with ANC
Figure-3; Kaplan Meier curve for overall survival with ALC

	Baseline distant metastases
	Present	Absent	p- value	Odds Ratio	95% Confidence Interval
ANC≥5500	113 (64%)	63 (36%)	0.024	1.65	(1.0-2.5)
ANC< 5500	92 (52%)	85 (48%)
ALC≥1680	99 (57%)	75 (43%)	0.65	0.9	(0.6-1.4)
ALC< 1680	106 (59%)	73 (41%)
AMC≥ 600	117 (66%)	59 (34%)	0.001	2.0	(1.3-3.0)
AMC< 600	88 (50%)	89 (50%)
AEC≥ 143	83 (62%)	51 (38%)	0.38	1.2	(0.7-2.0)
AEC< 143	76(57%)	58 (43%)
NLR≥3.3	126 (69%)	56 (31%)	< .0001	2.6	(1.7-4.0)
NLR< 3.3	79 (46%)	92 (54%)
MLR≥0.3	130 (68%)	62 (32%)	< .0001	2.4	(1.5-3.7)
MLR< 0.3	75 (46%)	86 (54%)
PLR≥0.15	108 (61%)	68 (39%)	0.2	1.3	(0.85-2.0)
PLR< 0.15	97 (55%)	80 (45%)

Table: The association between systemic inflammatory markers with the presence of distant metastases

Disclosures:

Osama Abu-Shawer indicated no relevant financial relationships.

Thabet Qapaja indicated no relevant financial relationships.

Motasem Alkhayyat indicated no relevant financial relationships.

Arjun Chatterjee indicated no relevant financial relationships.

Mohammed El-Dallal indicated no relevant financial relationships.

Muhammad Haseeb indicated no relevant financial relationships.

Osama Abu-Shawer, MD, MS¹, Thabet Qapaja, MD¹, Motasem Alkhayyat, MD², Arjun Chatterjee, MD², Mohammed El-Dallal, MD³, Muhammad Haseeb, MD, MSc⁴. C0016 - Prognostic Value of Systemic Inflammatory Markers in Patients With Pancreatic Adenocarcinoma, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.