Researchers at Tottori Prefectural Central Hospital, Japan, have recently found possible preoperative prognostic biomarkers for patients preparing for curative resection of pancreatic ductal adenocarcinomas (PDACs). Despite the surgical option of curative resection, patients are at risk of experiencing postoperative complications such as postoperative pancreatic fistula, and typically have poor prognoses.
The team isolated two biomarkers as strong indicators of poor prognosis in 43 patients in a hospital in Japan, when studying nine potential preoperative factors.
Findings published recently in the Journal of Pancreatic Cancer suggest two novel biomarkers could lead to the development of personalized treatment plans in patients diagnosed with PDACs. This could lead to safer clinical practice, fewer postoperative complications and improved survival rates in a condition that has previously been understood to have exceptionally poor positive prognoses.
Serum markers of chronic inflammation, nutrition, immunity and markers typical of tumors in patients with pancreatic ductal carcinomas were considered as potential prognostic indicators, including: measures of preoperative serum amylase, C-reactive protein/albumin ratio, neutrophil/lymphocyte ratio, prognostic nutritional index, carcinoembryonic antigen, and carbohydrate antigen 19-9. The effects of operative procedure, operation time and tumor stage were also studied.
The development of postoperative pancreatic fistula and patient survival were recorded and analyzed over 9 years. Of the 43 patients, 22.4% survived for 5 years postoperative intervention. Low prognostic nutrition index and high C-reactive protein/albumin ratio were identified as risk factors for poor survival following surgery.
After careful examination, researchers determined that C-reactive protein/albumin ratio and prognostic nutritional index were ‘useful’ biomarkers in the preoperative prognostic assessments for patients with operable PDACs.
The authors recommend preoperative assessment of patient C-reactive protein/albumin ratio and prognostic nutrition index when designing treatment plans and strategies, further suggesting that consideration and improvement of patient nutrition may improve the survival rate and risk of postoperative complications following curative resection of PDACs.
Sources: Ikeguchi M, Hanaki T, Endo K S et al. C-reactive protein/albumin ration and prognostic nutritional index are strong prognostic indictators of survival in resected pancreatic ductal adenocarcinoma. J. Pancreat. Cancer 3(1), 31–36 (2017); www.eurekalert.org/pub_releases/2017-08/mali-rip081017.php