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39P - Prognostic value of Neutrophil-Lymphocyte ratio in patients with advanced pancreatic cancer


06 Oct 2021




Wala Ben Kridis


Annals of Oncology (2021) 32 (suppl_6): S1345-S1371. 10.1016/annonc/annonc740


W. Ben Kridis1, M. Lajnef2, S. Khmiri2, A. Khanfir2

Author affiliations

  • 1 University of Sfax - Hopital Habib Bourguiba, Sfax/TN
  • 2 University of Sfax - Hopital Habib Bourguiba, 3029 - sfax/TN

Abstract 39P


Pancreatic cancer is an aggressive tumor with a poor prognosis and high rate of mortality. Recently, systemic inflammation-based prognostic markers have been established to predict the prognosis in patients with pancreatic cancer. Among those indicators, we aimed to investigate the utility of neutrophil-to-lymphocyte ratio (NLR) as prognostic factors in Tunisian advanced pancreatic cancer.


A retrospective study was conducted at the department of Medical Oncology in Sfax, including 31 patients treated for a locally advanced or metastatic pancreatic cancer, from 2011 to 2017. NLR was evaluated and correlated with survival. Value cutoffs were adopted to discriminate patients as follows: low NLR < 3 and high NLR≥6.


A total of 31 patients were included. The median age was 60 years (range 36-77). Sixty-one per cent were male and 29% had a performance status (PS) ≥2. The median duration to consultation was 2,7 months and the main symptom for consultation was abdominal pain (87%) followed by jaundice (29%) and weight loss (26%). The median size was 45 mm. Metastases were found in 16 patients (51,6%). Chemotherapy was indicated in 19 patients, in 38% in case of neoadjuvant situation and 51% for metastatic cases. NLR was <6 in 24 cases and ≥6 in 7 cases. The median overall survival (OS) was 7 months. The 1-year and 2-year OS were, respectively, 12.9% and 3.2%. NLR ≥6 was associated with lower OS (1-year OS 0% vs 16.7%, p=0.0001). Other prognosis factors were PS ≥2, high rate of CA19-9 and stage IV (p= 0.001, p=0.021, p=0.027).


Our study concluded that in addition to the other prognosis factors, inflammation-based markers such as NLR ≥6 may be useful as prognostic factors for advanced pancreatic cancer.

Legal entity responsible for the study

Habib Bourguiba Committee.


Has not received any funding.


All authors have declared no conflicts of interest.

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