Metastatik pankreas kanserli hastalarda beslenme ve İnflamasyona dayalı skorların prognostik değeri

Abstract

Amaç Pankreas kanseri oldukça agresif bir malignitedir ve hastaların büyük çoğunluğu ileri evrede tanı almaktadır. Güvenilir prognostik belirteçlerin tanımlanması, tedavi kararlarını yönlendirmek açısından önemlidir. Bu çalışma, metastatik pankreas kanserinde inflamasyon ve beslenme temelli indekslerin prognostik önemini değerlendirmeyi amaçlamıştır. Yöntem Evre IV pankreas kanseri tanılı toplam 162 hasta retrospektif olarak incelendi. Beslenme ve inflamasyon temelli skorlar başlangıç kan parametrelerinden hesaplandı. Prognoz, progresyonsuz sağkalım (PS) ve genel sağkalım (GS) açısından Kaplan–Meier ve Cox regresyon analizleriyle değerlendirildi. Bulgular Ortanca PS ve GS sırasıyla 5,4 ve 10,3 ay olarak bulundu. Çok değişkenli analizde, yüksek prognostik beslenme indeksi (PBİ) (HR = 0,72, p = 0,05) ve ileri akciğer kanseri inflamasyon indeksi (İAİ) (HR = 0,76, p = 0,05) daha iyi PS ile ilişkili bulundu. Buna karşın, yüksek sistemik immün inflamasyon indeks (Sİİ) (HR = 1,84, p = 0,013) ve sistemik inflamasyon yanıt indeksi (SİYİ) (HR = 2,11, p = 0,005) daha kısa PS ile ilişkiliydi. Ayrıca, yüksek PBİ (HR = 0,51, p = 0,02), İAİ (HR = 0,73, p = 0,05) ve hemoglobin–albumin–lenfosit–trombosit (HALT) skoru (HR = 0,72, p = 0,032) daha uzun GS ile ilişkili bulunurken, yüksek Sİİ (HR = 1,81, p = 0,007) ve pan-immün inflamasyon değeri (PİİD) (HR = 1,87, p = 0,037) daha kısa GS ile ilişkiliydi. Sonuç İnflamasyon ve beslenme temelli skorlar, metastatik pankreas kanserinde değerli prognostik biyobelirteçlerdir. Bu indekslerin kolay ulaşılabilir ve düşük maliyetli olması, klinik uygulamada risk sınıflandırması ve bireyselleştirilmiş tedavi planlamasında umut verici araçlar olmasını sağlamaktadır.

Keywords

• pankreas kanseri
• inflamasyon
• sağkalım
• prognostik beslenme indeksi

Prognostic value of nutrition and inflammation based scores in patients with metastatic pancreatic cancer

Abstract

Aims: Pancreatic cancer is a highly aggressive malignancy, with most patients presenting at an advanced stage. Identifying reliable prognostic markers is essential to guide treatment decisions. This study evaluated the prognostic significance of inflammation and nutrition-based indices in metastatic pancreatic cancer. Methods: A total of 162 patients with stage IV pancreatic cancer were retrospectively analyzed. Nutrition- and inflammationbased scores were calculated from baseline blood parameters. Progression-free survival (PFS) and metastatic overall survival (mOS) were evaluated using Kaplan–Meier and Cox regression analyses. Results: The median PFS and mOS were 5.4 and 10.3 months, respectively. In the multivariate analysis, a high prognostic nutritional index (PNI) (HR: 0.72, p: 0.048) and a high platelet-to-lymphocyte ratio (ALI) (HR: 0.76, p: 0.005) were associated with favorable PFS, whereas a high systemic immune-inflammation index (SII) (HR: 1.84, p: 0.013) and a high systemic inflammation response index (SIRI) (HR: 2.11, p: 0.005) predicted poor PFS. High PNI (HR: 0.51, p: 0.002), ALI (HR: 0.73, p: 0.047), and hemoglobin-albumin-lymphocyte-platelet (HALP) index (HR: 0.72, p: 0.032) were significantly associated with longer mOS, whereas high SII (HR: 1.81, p: 0.007) and pan-immune inflammation value (PIIV) (HR: 1.87, p: 0.037) were associated with shorter mOS. Conclusion: Inflammation-and nutrition-based scores are valuable prognostic biomarkers in metastatic pancreatic cancer. Their accessibility and low cost make them promising tools for risk stratification and individualized treatment planning in clinical practice.

Keywords

• Pancreatic cancer
• inflammation
• survival
• prognostic nutritional index

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