Preoperative lymphocyte count as a prognostic factor in resected pancreatic ductal adenocarcinoma

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a disease with a poor prognosis and a median survival of 12–18 months when resected with curative intent [ 1 x [1] Geer, R.J. and Brennan, M.F. Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg. 1993; 165: 68–72 Abstract | Full Text PDF | PubMed | Scopus (685) | Google Scholar See all References , 2 x [2] Nitecki, S.S., Sarr, M.G., Colby, T.V., and van Heerden, J.A. Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving?. Ann Surg. 1995; 221: 59–66 Crossref | PubMed | Google Scholar See all References , 3 x [3] Cameron, J.L., Crist, D.W., Sitzmann, J.V., Hruban, R.H., Boitnott, J.K., and Seidler, A.J. Factors influencing survival after pancreaticoduodenectomy for pancreatic cancer. Am J Surg. 1991; 161: 120–124 Abstract | Full Text PDF | PubMed | Scopus (521) | Google Scholar See all References , 4 x [4] Yeo, C.J., Abrams, R.A., Grochow, L.B., Sohn, T.A., Ord, S.E., and Hruban, R.H. Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival. A prospective, single-institution experience. Ann Surg. 1997; 225: 621–633 Crossref | PubMed | Scopus (545) | Google Scholar See all References , 5 x [5] Nagakawa, T., Konishi, I., Ueno, K., Ohta, T., Kayahara, M., and Miyazaki, I. Extended radical pancreatectomy for carcinoma of the head of the pancreas. Hepatogastroenterology. 1998; 45: 849–854 PubMed | Google Scholar See all References , 6 x [6] Nagakawa, T., Nagamori, M., Futakami, F., Tsukioka, Y., Kayahara, M., and Ohta, T. Results of extensive surgery for pancreatic carcinoma. Cancer. 1996; 77: 640–645 Crossref | PubMed | Scopus (170) | Google Scholar See all References , 7 x [7] Yeo, C.J., Cameron, J.L., Lillemoe, K.D., Sitzmann, J.V., Hruban, R.H., and Goodman, S.N. Pancreaticoduodenectomy for cancer of the head of the pancreas. 201 patients. Ann Surg. 1995; 221: 721–731 Crossref | PubMed | Scopus (884) | Google Scholar See all References , 8 x [8] Sohn, T.A., Yeo, C.J., Cameron, J.L., Koniaris, L., Kaushal, S., and Abrams, R.A. Resected adenocarcinoma of the pancreas – 616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg. 2000; 4: 567–579 Crossref | PubMed | Scopus (1110) | Google Scholar See all References , 9 x [9] Millikan, K.W., Deziel, D.J., Silverstein, J.C., Kanjo, T.M., Christein, J.D., and Doolas, A. Prognostic factors associated with resectable adenocarcinoma of the head of the pancreas. Am Surg. 1999; 65: 618–623 PubMed | Google Scholar See all References , 10 x [10] Conlon, K.C., Klimstra, D.S., and Brennan, M.F. Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors. Ann Surg. 1996; 223: 273–279 Crossref | PubMed | Scopus (608) | Google Scholar See all References , 11 x [11] Brennan, M.F., Kattan, M.W., Klimstra, D., and Conlon, K. Prognostic nomogram for patients undergoing resection for adenocarcinoma of the pancreas. Ann Surg. 2004; 240: 293–298 Crossref | PubMed | Scopus (219) | Google Scholar See all References ]. However, there are few actual 5-year survivors, with even fewer patients truly cured of the disease [ 10 x [10] Conlon, K.C., Klimstra, D.S., and Brennan, M.F. Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors. Ann Surg. 1996; 223: 273–279 Crossref | PubMed | Scopus (608) | Google Scholar See all References ] [10] . In a study of over 100,000 patients diagnosed with pancreatic cancer, only 9% were eligible for potentially curative resection [ 12 x [12] Sener, S.F., Fremgen, A., Menck, H.R., and Winchester, D.P. Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985–1995, using the National Cancer Database. J Am Coll Surg. 1999; 189: 1–7 Abstract | Full Text | Full Text PDF | PubMed | Scopus (629) | Google Scholar See all References ] [12] . The majority of pancreatic cancers are in the head of the gland, i.e. necessitating pancreaticoduodenectomy (PD). This is a major operative intervention normally associated with a high mortality and morbidity, although large series with no in-hospital or 30-day mortality have been reported from specialist centers [ 13 x [13] Cameron, J.L., Pitt, H.A., Yeo, C.J., Lillemoe, K.D., Kaufman, H.S., and Coleman, J. One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann Surg. 1993; 217: 430–435 Crossref | PubMed | Scopus (749) | Google Scholar See all References ] [13] .