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Usefulness of serum creatinine and cystatin C ratio as a screening tool for predicting prognosis in patients with pancreatic cancer.

Authors :
Tsukagoshi M
Watanabe A
Araki K
Ishii N
Hagiwara K
Hoshino K
Muranushi R
Harimoto N
Takizawa M
Shirabe K
Source :
Annals of gastroenterological surgery [Ann Gastroenterol Surg] 2023 Apr 25; Vol. 7 (5), pp. 784-792. Date of Electronic Publication: 2023 Apr 25 (Print Publication: 2023).
Publication Year :
2023

Abstract

Aim: This study aimed to evaluate the usefulness of the serum creatinine/cystatin C (Cr/CysC) ratio as a prognostic factor after pancreatic surgery in patients with pancreatic cancer.<br />Methods: We retrospectively analyzed the data of 88 patients with pancreatic ductal carcinoma who underwent pancreatic surgery from January 2017 to December 2020. CysC measured from frozen serum samples and circulating Cr levels were used to calculate the Cr/CysC ratio. The cutoff value of the Cr/CysC ratio was determined using receiver operating characteristic curves. Cox proportional hazards model analysis and survival curves were applied to identify the prognostic factors.<br />Results: The optimal cutoff value of the Cr/CysC ratio for predicting mortality after surgery was 1.05. This study included 20 (22.7%) and 68 (77.3%) patients with high and low Cr/CysC ratios, respectively. The low Cr/CysC ratio was significantly associated with female sex ( p  = 0.020) and higher levels of C-reactive protein ( p  = 0.020). The postoperative length of stay was significantly longer in patients with low Cr/CysC rates ( p  = 0.044). Patients with low Cr/CysC ratio showed poorer prognosis in relapse-free survival (hazard ratio [HR] = 3.33; 95% confidence interval [CI]: 1.54-4.20; p  = 0.002) and overall survival (HR = 2.52, 95% CI: 1.04-6.10, p  = 0.041), respectively, which were significantly worse than in those with high Cr/CysC ratios ( p  = 0.003 and 0.049, respectively).<br />Conclusion: The Cr/CysC ratio could be a useful screening tool for predicting the prognosis of patients with pancreatic ductal carcinoma undergoing pancreatic surgery.<br />Competing Interests: Author Ken Shirabe is an editorial board member of Annals of Gastroenterological Surgery. The other authors declare no conflict of interest for this article. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.<br /> (© 2023 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.)

Details

Language :
English
ISSN :
2475-0328
Volume :
7
Issue :
5
Database :
MEDLINE
Journal :
Annals of gastroenterological surgery
Publication Type :
Academic Journal
Accession number :
37663967
Full Text :
https://doi.org/10.1002/ags3.12671