Prognostic Usefulness Of Advanced Lung Cancer Inflammation Index In Locally-Advanced Pancreatic Carcinoma Patients Treated With Radical Chemoradiotherapy

Erkan Topkan; Huseyin Mertsoylu; Yurday Ozdemir; Ahmet Sezer; Ahmet Kucuk; Ali Ayberk Besen; Ozgur Ozyilkan; Ugur Selek

doi:10.2147/CMAR.S222297

Prognostic Usefulness Of Advanced Lung Cancer Inflammation Index In Locally-Advanced Pancreatic Carcinoma Patients Treated With Radical Chemoradiotherapy

Cancer Manag Res. 2019 Oct 7:11:8807-8815. doi: 10.2147/CMAR.S222297. eCollection 2019.

Authors

Erkan Topkan¹, Huseyin Mertsoylu², Yurday Ozdemir¹, Ahmet Sezer², Ahmet Kucuk³, Ali Ayberk Besen², Ozgur Ozyilkan², Ugur Selek^{4

5}

Affiliations

¹ Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey.
² Department of Medical Oncology, Baskent University Medical Faculty, Adana, Turkey.
³ Department of Radiation Oncology, Mersin City Hospital, Mersin, Turkey.
⁴ Department of Radiation Oncology, Koc University School of Medicine, Istanbul, Turkey.
⁵ Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.

Abstract

Background/aims: Previously advanced lung cancer inflammation index (ALI) has been demonstrated to have prognostic utility in the stratification of patients into distinctive survival groups, but the prognostic value of ALI has never been explored in the setting of locally advanced pancreatic carcinomas (LAPC) treated with concurrent chemoradiotherapy (CCRT). Hence, we aimed to investigate the prognostic value of pre-treatment ALI in LAPC patients who underwent radical CCRT.

Methods: Present retrospective cohort analysis incorporated 141 LAPC patients who received radical CCRT. Accessibility of baseline ALI cutoff(s) impacting survival outcomes was sought by receiver operating characteristic (ROC) curve analysis. Interaction between the ALI and overall- (OS) and progression-free survival (PFS) comprised our primary and secondary endpoints, respectively.

Results: At a median follow-up of 14.4 months (range: 3.2-74.2), the median PFS and OS were 7.5 (%95 CI: 5.9-9.1) and 14.6 months (%95 CI: 11.6-17.6), respectively. ROC curve analyses set the ideal ALI cutoff value at 25.3 (AUC: 75.6%; sensitivity: 72.7%; specificity: 70.3%) that exhibited significant associations with both the OS and PFS results. Patient stratification into two groups per ALI [≤25.3 (N=75) versus>25.3 (N=66)] showed that the ALI>25.3 group had significantly superior median OS (25.8 versus 11.4 months; P<0.001) and PFS (15.9 versus 6.0 months; P<0.001) durations than its ALI≤25.3 counterpart. Other factors exhibiting significantly better OS and PFS rates were N₀ stage (versus N1; P<0.05 for each endpoint) and CA 19-9 ≤90 U/mL (versus >90 U/mL; P<0.05 for each endpoint), respectively. These three factors were additionally asserted to be independent indicators of longer OS (P<0.05 for each) and PFS (P<0.05 for each) in multivariate analyses.

Conclusion: Results of this hypothesis-generating research proposed the pre-CCRT ALI as a novel robust associate of OS and PFS outcomes for LAPC patients undergoing CCRT.

Keywords: advanced lung cancer inflammation index; concurrent chemoradiotherapy; locally-advanced pancreas cancer; prognosis; survival outcomes.