Aims: The aim of this study was to investigate the prognostic significance of three basic inflammation-based factors in patients with advanced pancreatic cancer.

Methods: Retrospective data was collected for advanced pancreatic cancer patients treated between 1st Jan 2008 and 31st Dec 2012 at the Royal Perth Hospital. Data censor date was 8th May 2013. Information regarding baseline inflammation-based markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and modified Glasgow Prognostic Score (mGPS) along with survival data was collected from electronic patient records and RPH Cancer registry data. Cut-off values of <5 vs. ≥ 5 for NLR & <200 vs. ≥ 200 for PLR were used based on previous literature.

Results: 124 patients were identified. 84 patients had metastatic disease and 40 patients had locally advanced unresectable pancreatic cancer. Median survivals based on the three potential prognostic markers evaluated were: NLR <5 vs. ≥ 5 = 8.5m vs. 2.6m respectively (p=0.0007; HR 1.81); PLR <200 vs. ≥ 200 = 9.1m vs. 4m respectively (p=0.007; HR 1.64) & mGPS score 1, 2 3 = 8.3m, 9.6m, 1.8m respectively (p=0.0002).

Conclusions: Our findings suggest that the NLR, PLR and mGPS derived from routine blood tests can be used as clinically meaningful biomarkers to stratify advanced pancreatic cancer patients into different prognostic groups and assist with decision making regarding systemic anti-cancer therapy.