Predictive value of neutrophil-to-platelet ratio for postoperative prognosis in distal cholangiocarcinoma: A retrospective study.

PURPOSE: This study aimed to explore the value of neutrophil-to-platelet ratio (NPR) in predicting postoperative prognosis of distal cholangiocarcinoma(dCCA).

METHODS

The optimal cutoff value of NPR was determined using a receiver operator characteristic curve (ROC) analysis. Patients were divided into low- and high-NPR groups, and perioperative data and long-term survival were compared. Independent risk factors for postoperative tumor recurrence and long-term survival were identified using univariate and multivariate analyses. An NPR-based prediction model was established and verified using ROC, calibration curve, and decision curve analyses.

RESULTS

A total of 168 patients were included. The area under the ROC curve of preoperative NPR was 0.617, and the optimal cutoff value was 0.014. Postoperative disease-free survival and overall survival were significantly longer in the low-NPR group. Univariate and multivariate analyses indicated that NPR > 0.014 was an independent risk factor for postoperative recurrence (RR = 1.745, 95%CI: 1.027-2.965) and long-term survival (RR = 1.837, 95%CI: 1.127-2.993). The NPR-based prediction model could improve the predictive ability for the postoperative prognosis. Patients with a high preoperative NPR may have an advanced TNM stage and portal vein invasion.

CONCLUSION

Elevated NPR is an independent risk factor for postoperative tumor recurrence and a poor long-term prognosis in patients with dCCA.