World Journal of Surgery

, Volume 42, Issue 11, pp 3736–3745 | Cite as

The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Resected Patients with Pancreatic Adenocarcinoma

  • Le-ping Fang
  • Xiao-yan Xu
  • Yu Ji
  • Pu-wen HuangEmail author
Original Scientific Report



This research aims to analyze neutrophil-to-lymphocyte ratio (NLR) for resectable pancreatic ductal adenocarcinoma (PDAC) patients and reveal its predictive value.


We enrolled 389 pancreatic adenocarcinoma patients who had undergone curative surgery between January 1, 2008 and August 15, 2015 in Jiangsu Provincial People’s Hospital, and they were followed up until December 20, 2016. Among them, 219 patients had definite recurrence record in our hospital. The appropriate cutoff value for the NLR was obtained from X-tile software. The association between qualitative variables and NLR was analyzed by Chi-square test or Fisher’s exact test, and for quantitative values, the association was analyzed by independent Student’s t test. Additionally, survival analysis was performed by Kaplan–Meier plots. Independent prognostic factors were found according to Cox regression analysis.


Based on univariate analysis, the elevated preoperative NLR had an important influence on the decreased recurrence-free survival (RFS) (8.2 vs. 14.9 months) and overall survival (OS) (13.7 vs. 22 months), and this result also counted in the multivariate analysis. Regarding OS, both patients with or without postoperative chemotherapy can obtain benefits from low NLR according to subgroup analysis. Stage I and II pancreatic adenocarcinoma patients can get longer OS and RFS from low NLR, while patients with stage III cancer cannot. Regarding recurrence site, high NLR level was also related to distant metastasis (P = 0.02).


Preoperative NLR level could be a useful prognostic indication for resectable pancreatic adenocarcinoma patients.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Le-ping Fang
    • 1
  • Xiao-yan Xu
    • 1
  • Yu Ji
    • 1
  • Pu-wen Huang
    • 1
    Email author
  1. 1.Department of Oncologythe First Affiliated Hospital of Nanjing Medical UniversityNanjing CityChina

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