Wen ZL, Ren H, Fei H, Niu PH, Li ZF, Chen YT, Guo CG, Zhao DB. Prognostic significance of advanced lung cancer inflammation index in resectable pancreatic cancer: A retrospective study. World J Gastrointest Surg 2025; 17(9): 108551 [DOI: 10.4240/wjgs.v17.i9.108551]
Corresponding Author of This Article
Dong-Bing Zhao, Chief Physician, Doctoral Supervisor, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Beijing 100021, China. dbzhao@cicams.ac.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2025; 17(9): 108551 Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.108551
Prognostic significance of advanced lung cancer inflammation index in resectable pancreatic cancer: A retrospective study
Ze-Lin Wen, Hu Ren, He Fei, Peng-Hui Niu, Ze-Feng Li, Ying-Tai Chen, Chun-Guang Guo, Dong-Bing Zhao
Ze-Lin Wen, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Hu Ren, He Fei, Peng-Hui Niu, Ze-Feng Li, Chun-Guang Guo, Dong-Bing Zhao, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Ying-Tai Chen, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Beijing 100021, China
Co-first authors: Ze-Lin Wen and Hu Ren.
Author contributions: Wen ZL and Ren H assisted in data collection and organization, and provided guidance on data analysis and writing as the co-first authors of the paper; all authors contributed to data collection and analysis, wrote the original draft, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Supported by Special Research Fund for Central Universities, Peking Union Medical College, No. 3332023024; and Beijing Hope Run Special Fund of Cancer Foundation of China, No. LC2021B20.
Institutional review board statement: The study was approved by the Ethics Committee of our institution.
Informed consent statement: All patients provided informed consent.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Bing Zhao, Chief Physician, Doctoral Supervisor, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Beijing 100021, China. dbzhao@cicams.ac.cn
Received: April 17, 2025 Revised: June 10, 2025 Accepted: July 18, 2025 Published online: September 27, 2025 Processing time: 160 Days and 17.3 Hours
Abstract
BACKGROUND
Pancreatic cancer (PC), ranking among the most aggressive solid malignancies, currently lacks validated prognostic biomarkers to guide survival stratification. With a 5-year survival rate under 10%, this malignancy urgently requires precision tools for outcome prediction to optimize therapeutic decision-making.
AIM
To analyze whether the advanced lung cancer inflammation index (ALI) is a prognostic indicator for PC.
METHODS
Patients who were diagnosed with PC and underwent radical resection were included from January 2007 to January 2023 in a clinical center from National Cancer Center of China. The patients were divided into low and high ALI groups according to an ALI cut-off of 34.0 calculated with software X-tile. Overall survival (OS) and surgical outcomes were calculated between the two groups. Follow-up was conducted through telephone interview. Kaplan-Meier analysis was performed to estimate OS, while the log-rank test was utilized to compare OS among different tumor stages. Cox regression was used to identify independent risk factors for OS.
RESULTS
This study included 611 patients who underwent radical PC surgery. Using an ALI cutoff of 34.0, the patients were categorized into a high ALI group (n = 378) and a low ALI group (n = 233). The low ALI group had significantly lower body mass index, serum albumin, lymphocyte count, and ALI (P < 0.01), but higher neutrophil count, a higher proportion of head and neck PC, and longer operation time (P < 0.01). As for prognosis, the low ALI group had worse OS in stage I patients (P < 0.01), and low ALI (P = 0.018, hazard ratio = 0.784, 95% confidence interval: 0.641-0.960) independently conferred an increased risk for mortality.
CONCLUSION
Lower ALI is associated with worse OS for PC patients who underwent radical surgery. Patients demonstrating low ALI preoperatively require special attention from surgeons.
Core Tip: A total of 611 patients who underwent radical pancreatic cancer (PC) surgery were included in this study. The low advanced lung cancer inflammation index (ALI) group had significantly lower body mass index, serum albumin, lymphocyte count, and ALI, but higher neutrophil count, a higher proportion of head and neck PC, and longer operation time. Although there was difference in baseline information, Cox analysis was conducted. As for prognosis, the low ALI group had worse overall survival (OS) in stage I patients, and ALI was identified as an independent risk factor for OS.
