Cancer-associated inflammation is a key molecular feature of PC and may affect the clinical course. The aim of this study was to evaluate the prognostic relevance of SIRI based on peripheral neutrophil, monocyte, and lymphocyte counts in metastatic PC and its association with the metastatic site.
Retrospective analysis of the medical records of patients with pathologically confirmed metastatic PC between January 2011 and December 2016. Patients were classified as having liver metastases (LM) or extrahepatic metastases alone (EM). Associations with overall survival (OS) were analyzed using Cox proportional models.
A total of 37 patients were included (47 men; median age 63). Median TTP was 4 months and median OS was 6 months. 29 patients (78%) had LM and 8 (22%) EM. 33 patients (89%) received CT: 13 (40%) Gemcitabine (GEM) plus Nab-Paclitaxel, 9 (27%) GEM in monotherapy, 7 (21%) GEM plus Erlotinib and 4 (12%) an Oxaliplatine doublet. Mean Ca 19 9 levels in patients with LM were 199349 and with EM 9107. Univariate analysis identified SIRI scores ≥1,9 as significant risk factor for OS. Age, sex and high CA 19,9 levels had no prognostic significance for OS in all groups. Patients with LM showed a higher SIRI than those with EM (p = 0,03). Patients with SIRI scores < 1,9 (55%) compared to those who had SIRI scores ≥1,9 (45%) had a longer OS (p = 0,01). LM were significantly associated with shorter OS (hazard ratio [HR] 2.79; 95% confidence interval [CI] 1.36-5.34; p = 0,002) but not those with EM (HR 1.83; CI 0.71-4.72; p = 0,2). An SIRI ≥1,9 resulted in a shorter OS compared to an SIRI
SIRI is associated with survival in patients with metastatic PC. In patients with LM, unfavourable SIRI may be associated with higher tumor burden. In our experience, a baseline SIRI ≥1.9 duplicates the risk of mortality and this finding may allow better risk stratification.
Clinical trial identification
Legal entity responsible for the study
Medical Oncology Department, Hospital Universitario de La Princesa
All authors have declared no conflicts of interest.