Prognostic value of nutrition and inflammation based scores in patients with metastatic pancreatic cancer

Aims: Pancreatic cancer is a highly aggressive malignancy, with most patients presenting at an advanced stage. Identifying reliable prognostic markers is essential to guide treatment decisions. This study evaluated the prognostic significance of inflammation and nutrition-based indices in metastatic pancreatic cancer. Methods: A total of 162 patients with stage IV pancreatic cancer were retrospectively analyzed. Nutrition- and inflammationbased scores were calculated from baseline blood parameters. Progression-free survival (PFS) and metastatic overall survival (mOS) were evaluated using Kaplan–Meier and Cox regression analyses. Results: The median PFS and mOS were 5.4 and 10.3 months, respectively. In the multivariate analysis, a high prognostic nutritional index (PNI) (HR: 0.72, p: 0.048) and a high platelet-to-lymphocyte ratio (ALI) (HR: 0.76, p: 0.005) were associated with favorable PFS, whereas a high systemic immune-inflammation index (SII) (HR: 1.84, p: 0.013) and a high systemic inflammation response index (SIRI) (HR: 2.11, p: 0.005) predicted poor PFS. High PNI (HR: 0.51, p: 0.002), ALI (HR: 0.73, p: 0.047), and hemoglobin-albumin-lymphocyte-platelet (HALP) index (HR: 0.72, p: 0.032) were significantly associated with longer mOS, whereas high SII (HR: 1.81, p: 0.007) and pan-immune inflammation value (PIIV) (HR: 1.87, p: 0.037) were associated with shorter mOS. Conclusion: Inflammation-and nutrition-based scores are valuable prognostic biomarkers in metastatic pancreatic cancer. Their accessibility and low cost make them promising tools for risk stratification and individualized treatment planning in clinical practice.