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Background/aim: Recent studies have investigated a novel inflammation-based prognostic system using the combination of platelet count and neutrophil-lymphocyte ratio (COP-NLR). As platelet count decreases with liver damage, we hypothesized that COP-NLR could indicate both inflammation and hepatic reserve in patients with hepatocellular carcinoma (HCC). This study was conducted to clarify the prognostic significance of preoperative COP-NLR in patients with HCC., Patients and Methods: We enrolled 176 patients with histologically-proven HCC who underwent initial curative hepatectomy. Patients were assigned one point each for low platelet count (<15×10 4 /μl) or for high NLR (≥2.0), for hepatic-COP-NLR scores (h-COP-NLR) of 0, 1 or 2., Results: Five-year overall survival (OS) and recurrence-free survival (RFS) rates were 74.5±9%, and 62.2%±9.3% for score 0, 63.6±5.4% and 50.3%±5.6% for score 1, and 45.2±8.8% and 40.6±8.7% for score 2, respectively, and significantly differed (OS: p=0.01; RFS: p=0.03). In multivariate analysis, h-COP-NLR was an independent risk factor for tumor recurrence (HR=1.39, p=0.03) and death (HR=1.71, p=0.02)., Conclusion: h-COP-NLR was an independent predictor for prognosis of HCC patients after hepatic resection., (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: We retrospectively investigated the relationship between prognosis and combined neutrophil-to-lymphocyte ratio (NLR) and serum carbohydrate antigen 19-9 (CA19-9) levels in patients with recurrent pancreatic cancer., Patients and Methods: We enrolled 66 patients whose pancreatic cancer recurred., Results: Based on ROC analysis results, the patients were divided into NLR High (NLR ≥1.69) or NLR Low (NLR <1.69), and into CA19-9 High (CA19-9 ≥107.95 U/ml) or CA19-9 Low (CA19-9 <107.95 U/ml). When the patients were grouped by combined NLR and CA19-9, their 2-year survival rates were NLR Low /CA19-9 Low : 58.7%; NLR Low /CA19-9 High or NLR High /CA19-9 Low (grouped together): 11.2%; and NLR High /CA19-9 High : 0% (p<0.0001). Finally, in multivariate analysis, the combination of NLR and serum CA19-9 level was an independent prognostic factor in patients with recurrent pancreatic cancer., Conclusion: The combination of NLR and serum CA19-9 level is a useful prognostic indicator for recurrent pancreatic cancer., (Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Purpose: We evaluated prognostic indicators based on inflammatory and nutritional factors, namely, the modified Glasgow Prognostic Score (mGPS), the Prognostic Nutritional Index (PNI), the neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR), to determine their efficiency and significance after pancreaticoduodenectomy for pancreatic cancer., Methods: The subjects of this study were 46 patients who underwent pancreaticoduodenectomy for pancreatic cancer between October 2007 and December 2014. Patients were divided into preoperative mGPS (0/1 and 2), PNI (<40 and ≥40), NLR (<2.5 and ≥2.5), and PLR (<200 and ≥200) groups, to evaluate various perioperative outcomes., Results: Hemoglobin concentrations were significantly lower (P = 0.019), whereas intra-abdominal bleeding was significantly higher (P = 0.040) in the PNI (<40) group than in the PNI (≥40) group. The incidence of postoperative pneumonia was significantly higher in the mGPS (2) group (P = 0.009), and surgical complications greater than grade 3 (Clavien-Dindo classification) were significantly increased in the NLR (≥2.5) group (P = 0.041). Overall survival rates in the PNI (<40) (P = 0.019), NLR (≥2.5) (P = 0.001), and PLR (≥200) (P < 0.001) groups were significantly lower than those in the other groups. The PLR was the only independent prognostic indicator (P = 0.002) according to multivariate analysis., Conclusions: The mGPS, PNI, and NLR were effective predictive indicators of postoperative complications. The PLR was the most useful prognostic indicator for pancreatic cancer patients after pancreaticoduodenectomy.