The Neutrophil-to-Lymphocyte Ratio is a Prognostic Biomarker in An Ethnically Diverse Patient Population with Advanced Pancreatic Cancer

Michael Shusterman, Erin Jou, Andreas Kaubisch, Jennifer W. Chuy, Lakshmi Rajdev, Santiago Aparo, Justin Tang, Nitin Ohri, Abdissa Negassa, Sanjay Goel

Research output: Contribution to journalArticle

Abstract

Purpose: The neutrophil-to-lymphocyte ratio (NLR) is associated with decreased overall survival in patients with pancreatic adenocarcinoma (PAC) in studies including few minority patients. We investigated the association between NLR and survival in patients with advanced PAC in an ethnically diverse population. Methods: We retrospectively evaluated 226 patients with advanced PAC treated at Montefiore Medical Center between 2006 and 2015. Adjusted Cox proportion hazard regression models were utilized to derive effect estimates for survival duration. Results: Patients with a NLR ≤ 5 (126 patients, median age 66 years) were more likely to be non-Hispanic Black (30.8% vs. 20%), while patients with a NLR > 5 (70 patients, median age 66 years) were more likely to be non-Hispanic White (21.4% vs. 12.2%) or Hispanic (44.3% vs. 34%). A NLR > 5 compared with a NLR ≤ 5 was significantly associated with a worse overall survival when adjusted for a priori and exploratory variables from the univariate analysis (median survival 7.4 vs. 12 months, HR 1.650, 95% CI 1.139, 2.390). Conclusions: In an ethnically diverse population, elevated NLR is an independent marker of poor prognosis and a potentially valuable factor in driving therapeutic decisions and defining prognosis for patients in the locally advanced or metastatic for PAC setting, meriting investigation in prospective clinical trials.

Original languageEnglish (US)
JournalJournal of Gastrointestinal Cancer
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Pancreatic Neoplasms
Neutrophils
Biomarkers
Lymphocytes
Population
Adenocarcinoma
Survival
Survival Analysis
Hispanic Americans
Proportional Hazards Models
Clinical Trials

Keywords

  • Chemotherapy
  • Healthcare disparities
  • Inflammation
  • Pancreatic cancer
  • Prognostic factors

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

@article{35539b917a074680bdcd9568a4da93f9,
title = "The Neutrophil-to-Lymphocyte Ratio is a Prognostic Biomarker in An Ethnically Diverse Patient Population with Advanced Pancreatic Cancer",
abstract = "Purpose: The neutrophil-to-lymphocyte ratio (NLR) is associated with decreased overall survival in patients with pancreatic adenocarcinoma (PAC) in studies including few minority patients. We investigated the association between NLR and survival in patients with advanced PAC in an ethnically diverse population. Methods: We retrospectively evaluated 226 patients with advanced PAC treated at Montefiore Medical Center between 2006 and 2015. Adjusted Cox proportion hazard regression models were utilized to derive effect estimates for survival duration. Results: Patients with a NLR ≤ 5 (126 patients, median age 66 years) were more likely to be non-Hispanic Black (30.8{\%} vs. 20{\%}), while patients with a NLR > 5 (70 patients, median age 66 years) were more likely to be non-Hispanic White (21.4{\%} vs. 12.2{\%}) or Hispanic (44.3{\%} vs. 34{\%}). A NLR > 5 compared with a NLR ≤ 5 was significantly associated with a worse overall survival when adjusted for a priori and exploratory variables from the univariate analysis (median survival 7.4 vs. 12 months, HR 1.650, 95{\%} CI 1.139, 2.390). Conclusions: In an ethnically diverse population, elevated NLR is an independent marker of poor prognosis and a potentially valuable factor in driving therapeutic decisions and defining prognosis for patients in the locally advanced or metastatic for PAC setting, meriting investigation in prospective clinical trials.",
keywords = "Chemotherapy, Healthcare disparities, Inflammation, Pancreatic cancer, Prognostic factors",
author = "Michael Shusterman and Erin Jou and Andreas Kaubisch and Chuy, {Jennifer W.} and Lakshmi Rajdev and Santiago Aparo and Justin Tang and Nitin Ohri and Abdissa Negassa and Sanjay Goel",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s12029-019-00316-8",
language = "English (US)",
journal = "Journal of Gastrointestinal Cancer",
issn = "1941-6628",
publisher = "Humana Press",

}

TY - JOUR

T1 - The Neutrophil-to-Lymphocyte Ratio is a Prognostic Biomarker in An Ethnically Diverse Patient Population with Advanced Pancreatic Cancer

AU - Shusterman, Michael

AU - Jou, Erin

AU - Kaubisch, Andreas

AU - Chuy, Jennifer W.

AU - Rajdev, Lakshmi

AU - Aparo, Santiago

AU - Tang, Justin

AU - Ohri, Nitin

AU - Negassa, Abdissa

AU - Goel, Sanjay

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: The neutrophil-to-lymphocyte ratio (NLR) is associated with decreased overall survival in patients with pancreatic adenocarcinoma (PAC) in studies including few minority patients. We investigated the association between NLR and survival in patients with advanced PAC in an ethnically diverse population. Methods: We retrospectively evaluated 226 patients with advanced PAC treated at Montefiore Medical Center between 2006 and 2015. Adjusted Cox proportion hazard regression models were utilized to derive effect estimates for survival duration. Results: Patients with a NLR ≤ 5 (126 patients, median age 66 years) were more likely to be non-Hispanic Black (30.8% vs. 20%), while patients with a NLR > 5 (70 patients, median age 66 years) were more likely to be non-Hispanic White (21.4% vs. 12.2%) or Hispanic (44.3% vs. 34%). A NLR > 5 compared with a NLR ≤ 5 was significantly associated with a worse overall survival when adjusted for a priori and exploratory variables from the univariate analysis (median survival 7.4 vs. 12 months, HR 1.650, 95% CI 1.139, 2.390). Conclusions: In an ethnically diverse population, elevated NLR is an independent marker of poor prognosis and a potentially valuable factor in driving therapeutic decisions and defining prognosis for patients in the locally advanced or metastatic for PAC setting, meriting investigation in prospective clinical trials.

AB - Purpose: The neutrophil-to-lymphocyte ratio (NLR) is associated with decreased overall survival in patients with pancreatic adenocarcinoma (PAC) in studies including few minority patients. We investigated the association between NLR and survival in patients with advanced PAC in an ethnically diverse population. Methods: We retrospectively evaluated 226 patients with advanced PAC treated at Montefiore Medical Center between 2006 and 2015. Adjusted Cox proportion hazard regression models were utilized to derive effect estimates for survival duration. Results: Patients with a NLR ≤ 5 (126 patients, median age 66 years) were more likely to be non-Hispanic Black (30.8% vs. 20%), while patients with a NLR > 5 (70 patients, median age 66 years) were more likely to be non-Hispanic White (21.4% vs. 12.2%) or Hispanic (44.3% vs. 34%). A NLR > 5 compared with a NLR ≤ 5 was significantly associated with a worse overall survival when adjusted for a priori and exploratory variables from the univariate analysis (median survival 7.4 vs. 12 months, HR 1.650, 95% CI 1.139, 2.390). Conclusions: In an ethnically diverse population, elevated NLR is an independent marker of poor prognosis and a potentially valuable factor in driving therapeutic decisions and defining prognosis for patients in the locally advanced or metastatic for PAC setting, meriting investigation in prospective clinical trials.

KW - Chemotherapy

KW - Healthcare disparities

KW - Inflammation

KW - Pancreatic cancer

KW - Prognostic factors

UR - http://www.scopus.com/inward/record.url?scp=85074847213&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074847213&partnerID=8YFLogxK

U2 - 10.1007/s12029-019-00316-8

DO - 10.1007/s12029-019-00316-8

M3 - Article

C2 - 31677056

AN - SCOPUS:85074847213

JO - Journal of Gastrointestinal Cancer

JF - Journal of Gastrointestinal Cancer

SN - 1941-6628

ER -