Authors
Ryo Saito, Hidetake Amemiya, Wataru Izumo, Taishu Oka, Suguru Maruyama, Koichi Takiguchi, Katsutoshi Shoda, Kensuke Shiraishi, Shinji Furuya, Yoshihiko Kawaguchi, Hiromichi Kawaida, Daisuke Ichikawa
Published in
Surgery today. Jul 13, 2026. Epub Jul 13, 2026.
Abstract
Predictive markers of the response to neoadjuvant chemotherapy (NAC) in pancreatic cancer are limited. We investigated whether the absolute lymphocyte count (ALC), a surrogate marker of host immune competence, could predict the pathological response to NAC.
This retrospective single-center study included patients with pancreatic ductal adenocarcinoma who underwent pancreatectomy after NAC (2019 and 2025). The pathological response was classified as good (JPS grade ≥ 2) or poor (grade 1a/1b). Logistic regression was used to identify predictors of a good response. Locoregional recurrence was analyzed using competing risk methods.
Among the 110 patients, 20 (18.2%) achieved a good pathological response. The Preoperative ALC (measured immediately before surgery) was higher in the good-response group (median 1544 vs. 1053/µL, p = 0.014). In a multivariable analysis, ALC independently predicted a good response (OR per 500/µL, 1.59; 95% CI 1.09-2.32; p = 0.016), whereas CA19-9 was not significant. Patients with a good pathological response had a lower cumulative incidence of locoregional recurrence (3-year: 7.0% vs. 37.6%, p = 0.036).
Preoperative ALC predicts the pathological response to NAC and reflects host immune competence relevant to local tumor control. As a simple and widely available biomarker, ALC may aid in the perioperative decision-making for pancreatic cancer.
PMID:
42439924
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.
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