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

Abstract

Background: 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.

Aim: To analyze whether the advanced lung cancer inflammation index (ALI) is a prognostic indicator for PC.

Methods: 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.

Results: 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.

Conclusion: Lower ALI is associated with worse OS for PC patients who underwent radical surgery. Patients demonstrating low ALI preoperatively require special attention from surgeons.