Predictive value of preoperative CA19-9 and neutrophil-to-lymphocyte ratio for early recurrence in patients with resected pancreatic ductal adenocarcinoma.

Abstract

Objectives: Pancreatic ductal adenocarcinoma (PDAC) has a high recurrence rate post-curative surgery. This study aimed to evaluate the combined predictive value of preoperative carbohydrate antigen 19-9 (CA19-9) and neutrophil-to-lymphocyte ratio (NLR) for early recurrence in resected PDAC patients.

Methods: This was a single-centre retrospective study involving 151 patients diagnosed with PDAC. Data on patient demographics, clinical characteristics and preoperative haematological parameters were collected. Early recurrence was defined as recurrence within the first 12 months after surgery. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with early recurrence. Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) analyses were used to assess the diagnostic performance of CA19-9, NLR and their combination.

Results: Among 151 patients (median follow-up: 21 months), 32.45% (n = 49) experienced early recurrence. Multivariate logistic regression analysis revealed that preoperative CA19-9 levels and NLR were independently associated with early recurrence. ROC curve analysis demonstrated that the combination of NLR and CA19-9 had significantly better performance in predicting early recurrence compared to NLR or CA19-9 alone.

Conclusion: The combination of preoperative CA19-9 and NLR enhances predictive accuracy for early recurrence in PDAC, offering a useful tool for postoperative risk stratification.