The Prognostic Role of Systemic Inflammatory Response Index in Surgically Treated Pancreatic Ductal Adenocarcinoma Patients

Year 2025, Volume: 9 Issue: 3, 612 - 618, 30.09.2025

Eda Çalışkan Yıldırım , Savaş Gökçek Mehmet Uzun , Faruk Recep Özalp Tarkan Unek , Özgül Sağol , İlkay Tuğba Ünek

https://doi.org/10.30621/jbachs.1735985

Abstract

Background:
Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy despite advances in treatment. The systemic inflammatory response index (SIRI), a composite marker of neutrophils, monocytes, and lymphocytes, has been proposed as a prognostic biomarker in various cancers. However, its role in resectable PDAC is not well established.
Methods:
This retrospective study analyzed 82 patients who underwent curative-intent surgery for PDAC between 2011 and 2021. Preoperative SIRI was calculated as (neutrophils × monocytes) / lymphocytes using blood counts obtained within one week before surgery. The optimal SIRI cut-off for overall survival (OS) prediction was determined using ROC analysis. Survival outcomes were assessed via Kaplan-Meier curves and Cox regression models.
Results:
The optimal SIRI cut-off was 1.36 (AUC: 0.738). Patients with SIRI ≤1.36 had significantly longer OS than those with SIRI >1.36 (42 vs. 22 months, p=0.013), including among early-stage patients. In multivariate analysis, SIRI >1.36 remained an independent predictor of poor OS (HR: 1.87, 95% CI: 1.08–3.21, p=0.023), along with age, ECOG status, and disease stage.
Conclusions:
Preoperative SIRI is an independent prognostic marker in resectable PDAC and may help identify high-risk patients who could benefit from intensified follow-up or additional therapeutic strategies. Prospective multicenter studies are warranted to validate these findings and integrate SIRI into clinical risk models.

Keywords

pancreatic ductal adenocarcinoma(PDAC), systemic inflammatory response index(SIRI), , prognostic factor , overall survival

Ethical Statement

Ethics Committee Approval: The study was approved by Ethics Board of Dokuz Eylul University (Decision number 2021/29-12). Informed consent is not required in retrospective studies due to legal regulations in our country.

Supporting Institution

none

Thanks

none

The Prognostic Role of Systemic Inflammatory Response Index in Surgically Treated Pancreatic Ductal Adenocarcinoma Patients

Abstract

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