Prognostic significance of advanced lung cancer inflammation index in resectable pancreatic cancer: A retrospective study.

Pancreatic cancer (PC), ranking among the most aggressive solid malignancies, currently lacks validated prognostic biomarkers to guide survival stratification. With a 5-year survival rate under 10%, this malignancy urgently requires precision tools for outcome prediction to optimize therapeutic decision-making. To analyze whether the advanced lung cancer inflammation index (ALI) is a prognostic indicator for PC. Patients who were diagnosed with PC and underwent radical resection were included from January 2007 to January 2023 in a clinical center from National Cancer Center of China. The patients were divided into low and high ALI groups according to an ALI cut-off of 34.0 calculated with software X-tile. Overall survival (OS) and surgical outcomes were calculated between the two groups. Follow-up was conducted through telephone interview. Kaplan-Meier analysis was performed to estimate OS, while the log-rank test was utilized to compare OS among different tumor stages. Cox regression was used to identify independent risk factors for OS. This study included 611 patients who underwent radical PC surgery. Using an ALI cutoff of 34.0, the patients were categorized into a high ALI group (n = 378) and a low ALI group (n = 233). The low ALI group had significantly lower body mass index, serum albumin, lymphocyte count, and ALI (P < 0.01), but higher neutrophil count, a higher proportion of head and neck PC, and longer operation time (P < 0.01). As for prognosis, the low ALI group had worse OS in stage I patients (P < 0.01), and low ALI (P = 0.018, hazard ratio = 0.784, 95% confidence interval: 0.641-0.960) independently conferred an increased risk for mortality. Lower ALI is associated with worse OS for PC patients who underwent radical surgery. Patients demonstrating low ALI preoperatively require special attention from surgeons.