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Purpose <p>Resectability in pancreatic cancer (PC) is determined by anatomical, biological, and conditional (ABC) criteria. However, the pretreatment prognostic markers for unresectable locally advanced (UR-LA) PC are insufficient. This study aimed to identify the baseline predictors of survival and establish an inflammation-nutrition-based prognostic score.</p> Methods <p>Thirty-nine patients with UR-LA PC who received chemotherapy or chemoradiotherapy were retrospectively evaluated. Pretreatment biomarkers, including systemic immune-inflammation index (SIII) and body mass index (BMI), were analyzed using Cox proportional hazards models.</p> Results <p>Multivariable analysis identified BMI &lt; 18.5&#xa0;kg/m² (PFS: HR 3.79, <i>p</i> = 0.003; OS: HR 2.88, <i>p</i> = 0.03) and SIII &gt; 900/µL (PFS: HR 3.71, <i>p</i> = 0.002; OS: HR 4.25, <i>p</i> = 0.02) as independent predictors of worse outcomes. High SIII was correlated with elevated neutrophil-to-lymphocyte ratio and lower prognostic nutritional index, whereas low BMI was associated with sarcopenia and reduced feasibility of conversion surgery. A pretreatment SIII/BMI score (0–2 points) effectively stratified survival: median PFS was 16.4, 7.3, and 4.3 months, and median OS was 31.1, 18.0, and 7.1 months for scores 0, 1, and 2, respectively.</p> Conclusions <p>Pretreatment SIII and BMI are strong independent prognostic markers for UR-LA PC. The SIII/BMI score is a practical pretreatment tool aligned with the ABC framework to support individualized treatment planning.</p>

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Prognostic stratification of unresectable locally advanced pancreatic cancer using a combination of inflammatory and nutritional indices: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年6月3日

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  • Michinori Matsumoto,
  • Masashi Tsunematsu,
  • Kenei Furukawa,
  • Koichiro Haruki,
  • Yoshihiro Shirai,
  • Tadashi Uwagawa,
  • Takeshi Gocho,
  • Shinji Onda,
  • Mitsuru Yanagaki,
  • Toru Ikegami

摘要

Purpose

Resectability in pancreatic cancer (PC) is determined by anatomical, biological, and conditional (ABC) criteria. However, the pretreatment prognostic markers for unresectable locally advanced (UR-LA) PC are insufficient. This study aimed to identify the baseline predictors of survival and establish an inflammation-nutrition-based prognostic score.

Methods

Thirty-nine patients with UR-LA PC who received chemotherapy or chemoradiotherapy were retrospectively evaluated. Pretreatment biomarkers, including systemic immune-inflammation index (SIII) and body mass index (BMI), were analyzed using Cox proportional hazards models.

Results

Multivariable analysis identified BMI < 18.5 kg/m² (PFS: HR 3.79, p = 0.003; OS: HR 2.88, p = 0.03) and SIII > 900/µL (PFS: HR 3.71, p = 0.002; OS: HR 4.25, p = 0.02) as independent predictors of worse outcomes. High SIII was correlated with elevated neutrophil-to-lymphocyte ratio and lower prognostic nutritional index, whereas low BMI was associated with sarcopenia and reduced feasibility of conversion surgery. A pretreatment SIII/BMI score (0–2 points) effectively stratified survival: median PFS was 16.4, 7.3, and 4.3 months, and median OS was 31.1, 18.0, and 7.1 months for scores 0, 1, and 2, respectively.

Conclusions

Pretreatment SIII and BMI are strong independent prognostic markers for UR-LA PC. The SIII/BMI score is a practical pretreatment tool aligned with the ABC framework to support individualized treatment planning.