Toggle Main Menu Toggle Search

Open Access padlockePrints

Prognostic significance of pre-operative C-reactive protein and the neutrophil-lymphocyte ratio in resectable pancreatic cancer: A systematic review

Lookup NU author(s): Sanjay PandanaboyanaORCiD


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


© 2014 International Hepato-Pancreato-Biliary Association.Background Better pre-operative risk stratification may improve patient selection for pancreatic resection in pancreatic cancer. C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR) have demonstrated prognostic value in some cancers. The role of CRP and NLR in predicting outcome in pancreatic cancer after curative resection is not well established. Methods An electronic search of MEDLINE, EMBASE and CINAHL was performed to identify studies assessing survival in patients after pancreatic cancer resection with high or low pre-operative CRP or NLR. Systematic review was undertaken using the PRISMA protocol. Results In total, 327 studies were identified with 10 reporting on survival outcomes after a pancreatic resection in patients with high or low CRP, NLR or both. All but one paper showed a trend of lower inflammatory markers in patients with longer survival. Three studies from six showed low CRP to be independently associated with increased survival and two studies of eight showed the same for NLR. All studies were retrospective cohort studies of low to moderate quality. Discussion Inflammatory markers might prove useful guides to the management of resectable pancreatic cancer but, given the poor quality of evidence, further longitudinal studies are required before incorporating pre-operative inflammatory markers into clinical decision making.

Publication metadata

Author(s): Stevens L, Pathak S, Nunes QM, Pandanaboyana S, Macutkiewicz C, Smart N, Smith AM

Publication type: Review

Publication status: Published

Journal: HPB

Year: 2015

Volume: 17

Issue: 4

Pages: 285-291

Print publication date: 01/04/2015

Acceptance date: 22/09/2014

ISSN (print): 1365-182X

ISSN (electronic): 1477-2574

Publisher: Blackwell Publishing Ltd


DOI: 10.1111/hpb.12355

PubMed id: 25431369