PROGNOSTIC POWER OF INFLAMMATORY RESPONSE SCORING SYSTEMS IN PERIAMPULLARY PANCREATIC CANCER: A SYSTEMATIC REVIEW

  • Majid Ali University Hospitals of Coventry and Warwickshire http://orcid.org/0000-0002-3243-9638
  • Alexia Farrugia University Hospitals of Coventry and Warwickshire
  • Ricky Bhogal University Hospitals of Coventry and Warwickshire
  • Saboor Khan University Hospitals of Coventry and Warwickshire
  • Gabriele Marangoni University Hospitals of Coventry and Warwickshire
  • Jawad Ahmad University Hospitals of Coventry and Warwickshire

Abstract

Introduction: Assessment of systemic inflammatory response forms the basis of several scoring systems that attempt to prognosticate patients with periampullary pancreatic carcinoma (PPC). We assessed the validity of three of these scoring systems for patients’ prognosis following intervention for PPC: Glasgow prognostic score (GPS) and its modified version (mGPS), platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR).

Methods: EMBASE and MEDLINE databases were searched for all published studies until September 2018 using comprehensive text word and MeSH terms. Meta-analysis of observational studies in epidemiology guidelines was followed. All identified studies were analysed and relevant studies were included in the review.

Results: Three studies which assessed the role of GPS, four studies that evaluated the use of NLR and three that assessed the role of PLR in patients with PPC were identified. None of these studies demonstrated any value in the pre-operative assessment of patients with PPC. The limited number of studies available precluded further statistical analysis.

Conclusions: Based on available evidence, GPS, NLR and PLR do not appear to be useful scoring systems to predict prognosis of patients with PPC. Larger studies are warranted before the application of inflammatory scoring systems could be recommended in patients with PPC.

Key words: Periampullary cancer, Glasgow prognostic score, modified Glasgow prognostic score, platelet-lymphocyte ratio, neutrophil-lymphocyte ratio

Author Biography

Majid Ali, University Hospitals of Coventry and Warwickshire

Senior Clinical Fellow HPB / General Surgery

University Hospitals Of Coventry and Warwickshire

References

Bourgouin S, Ewald J, Mancini J, et al. Predictors of survival in ampullary, bile duct and duodenal cancers following pancreaticoduodenectomy: A 10-year multicentre analysis. J Gastrointest Surg 2015;19:1247-55.

O’Connell JB, Maggard MA, Manunga J Jr., et al. Survival after resection of ampullary carcinoma: A national population-based study. Ann Surg Oncol 2008; 15:1820-7.

Lemke J, Schäfer D, Sander S, et al. Survival and prognostic factors in pancreatic and ampullary cancer. Anticancer Res 2014;34:3011-20.

Poon RT, Fan ST. Decreasing the pancreatic leak rate after pancreaticoduodenectomy. Adv Surg 2008;42:33-48.

Shah OJ, Robbani I, Shah P, et al. A selective approach to the surgical management of periampullary cancer patients and its outcome. Hepatobiliary Pancreat Dis Int 2014;13:628-33.

McMillan DC. The systemic inflammation-based glasgow prognostic score: A decade of experience in patients with cancer. Cancer Treat Rev 2013;39:534-40.

Ahmad J, Grimes N, Farid S, et al. Inflammatory response related scoring systems in assessing the prognosis of patients with pancreatic ductal adenocarcinoma: A systematic review. Hepatobiliary Pancreat Dis Int 2014;13: 474-81.

Watt DG, Roxburgh CS, White M, et al. A survey of attitudes towards the clinical application of systemic inflammation based prognostic scores in cancer. Mediators Inflamm 2015;2015:7.

Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 2000;283:2008-12.

Garcea G, Cairns V, Berry DP, et al. Improving the diagnostic yield from staging laparoscopy for periampullary malignancies: The value of preoperative inflammatory markers and radiological tumor size. Pancreas 2012;41:233 7.

Lowe MC, Coban I, Adsay NV, et al. Important prognostic factors in adenocarcinoma of the ampulla of vater. Am Surg 2009;75:754-60.

Kumamoto Y, Kaizu T, Tajima H, et al. Neutrophil-to-lymphocyte ratio as a predictor of postoperative morbidity in patients with distal cholangiocarcinoma. Mol Clin Oncol 2018;9:362-8.

Hamed MO, Roberts KJ, Smith AM, et al. Elevated pre-operative neutrophil to lymphocyte ratio predicts disease free survival following pancreatic resection for periampullary carcinomas. Pancreatology 2013; 13:534-8.

Demirci NS, Erdem GU. Prognostic role of neutrophil-to-lymphocyte ratio (NLR) in patients with operable ampullary carcinoma. Bosn J Basic Med Sci 2018;18:268-74.

Sakka N, Smith RA, Whelan P, et al. A preoperative prognostic score for resected pancreatic and periampullary neuroendocrine tumours. Pancreatology 2009;9: 670-6.

Smith RA, Bosonnet L, Ghaneh P, et al. The platelet-lymphocyte ratio improves the predictive value of serum CA19-9 levels in determining patient selection for staging laparoscopy in suspected periampullary cancer. Surgery 2008;143:658-66.

Demirci NS, Ozdemir NY, Erdem GU, et al. Preoperative platelet-to lymphocyte ratio is a predictor of prognosis in patients with ampullary carcinoma. Bratisl Lek Listy 2018;119:180-6.

McKay CJ, Glen P, McMillan DC. Chronic inflammation and pancreatic cancer. Best Pract Res Clin Gastroenterol 2008;22:65-73.

Ahn DH, Bekaii-Saab T. Ampullary cancer: An overview. Am Soc Clin Oncol Educ Book 2014;112-5.

Yamada S, Fujii T, Yabusaki N, et al. Clinical implication of inflammation-based prognostic score in pancreatic cancer: Glasgow prognostic score is the most reliable parameter. Medicine (Baltimore) 2016;95:e3582.

Shirai Y, Shiba H, Sakamoto T, et al. Preoperative platelet to lymphocyte ratio predicts outcome of patients with pancreatic ductal adenocarcinoma after pancreatic resection. Surgery 2015;158:360-5.

Momi N, Kaur S, Krishn SR, et al. Discovering the route from inflammation to pancreatic cancer. Minerva Gastroenterol Dietol 2012;58:283-97.

Forrest LM, McMillan DC, McArdle CS, et al. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 2004;90:1704-6.

Ni XC, Yi Y, Fu YP, et al. Prognostic value of the modified glasgow prognostic score in patients undergoing radical surgery for hepatocellular carcinoma. Medicine (Baltimore) 2015;94:e1486.

Gomez D, Farid S, Malik HZ, et al. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma. World J Surg 2008;32:1757-62.

Templeton AJ, Ace O, McNamara MG, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: A systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2014;23:1204-12.

Published
2019-06-30
How to Cite
1.
Ali M, Farrugia A, Bhogal R, Khan S, Marangoni G, Ahmad J. PROGNOSTIC POWER OF INFLAMMATORY RESPONSE SCORING SYSTEMS IN PERIAMPULLARY PANCREATIC CANCER: A SYSTEMATIC REVIEW. J Cancer Allied Spec [Internet]. 2019Jun.30 [cited 2022Dec.4];5(2). Available from: https://journals.sfu.ca/jcas/index.php/jcas/article/view/204