Volume 25, Issue 110, April, 2021

Laboratory prognostic factors correspondence to independent postoperative histo-pathological prognostic factors in pancreatic ductal adenocarcinoma

Ahmed Tabaan Alenezi

Hepatobiliary and Pancreatic Surgery Fellow at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

ABSTRACT

Background: Investigating the various prognostic factors affecting pancreatic cancer prognosis is of great value in their management during clinical practice. This study aimed to identify all these prognostic factors used in the systematic review in a correlation analysis to conduct their influence on pancreatic cancer patients. Material and Methods: Systematic review search was conducted in PubMed, EMBASE, and EBSCO through July 2020. The meta-analysis was applied in 32 study articles and reported their hazard ratios (HRs), 95% confidence intervals (CIs), and their effects on the prognosis of the pancreatic cancer patients. Results: Thirty-two studies with 7778 patients were included in the study. The pooled analysis indicated bad prognosis in lymph node metastasis (HR= 1.61; 95% CI; 1.01-2.22), lymph node ratio (HR= 2.63; 95% CI; 1.23-6.50), lymphatic invasion (HR= 1.29; 95% CI; 0.89-1.69), lymphovascular invasion (HR= 2.08; 95% CI; 0.38-3.79), vascular invasion (HR= 1.55; 95% CI; 1.04-2.25), duodenal invasion (HR= 1.17; 95% CI; 0.95-1.38), NLR (HR= 1.11; 95% CI; 1.03-1.19), PLR (HR= 1.04; 95% CI; 0.95-1.13), neutrophil count (HR= 2.94; 95% CI; 0.18-5.70) and good prognosis with high LMR (HR= 0.83; 95% CI; 0.74-0.93) while the marginal invasion (HR= 1.00; 95% CI; 0.24-1.75). Conclusion: The results of the meta-analysis showed that the following prognostic factors; lymph node metastasis, lymph node ratio, lymphovascular invasion, lymphatic invasion, vascular invasion, duodenal invasion, NLR, PLR, neutrophil count and lymphocyte count are of worse prognosis. However, high LMR referred to a good prognosis in pancreatic cancer patients. We recommend physicians and health care providers to deem the aforesaid results while assessing the prognosis among pancreatic adenocarcinoma patients.

Keywords: Pancreatic Ductal Adenocarcinoma, lymph node metastasis, pancreatic Malignancy, Histo-pathology, Prognostic factors, management

Medical Science, 2021, 25(110), 788-805

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