Abstract Systemic inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), albumin, lactate dehydrogenase (LDH), and vitamin B12, have been identified as potential prognostic indicators in pancreatic ductal adenocarcinoma (PDAC). This study evaluates the prognostic impact of these markers in elderly PDAC patients and their association with clinical outcomes. We conducted a retrospective analysis of 42 PDAC patients over 60 years old, who were treated at Cantonal Hospital Baselland from January 2018 to February 2022. Demograpfic, clinical and laboratory data were collected from electronic records. Routine laboratory parameters included biomarkers such as NLR, CRP, albumin, LDH, and vitamin B12. Cox proportional hazards models were used to determine the prognostic significance of each variable. Elevated CRP (>10 mg/L) was associated with a higher risk of death (HR 3.38, 95% CI 1.18-9.66, p=0.023). Although not statistically significant, a higher NLR (>4) and elevated LDH levels (>250 U/L), as well as hypoalbuminemia (<35 g/L) were linked to poorer survival. Chemotherapy improved survival (HR 0.076, 95% CI 0.02-0.29, p<0.001), while advanced metastatic disease increased mortality risk (HR 6.216, 95% CI 2.00-19.28, p=0.002). Older age (≥75 years) was an independent predictor of poorer survival (HR 4.88, 95% CI 1.65-14.39, p=0.004). This study underscores the importance of systemic inflammatory markers in predicting survival in elderly PDAC patients. Elevated CRP and low albumin levels were significant predictors of poor prognosis. While not statistically significant, higher NLR and LDH levels showed worse outcomes. Incorporating inflammatory markers into prognostic models may aid in drafting tailored treatment strategies, however prospective studies are warranted for clinical validation.
Sgries et al. (Thu,) studied this question.