ArticleJournal of gastrointestinal oncology2026
Prognostic value of lactate dehydrogenase-to-albumin ratio in metastatic/recurrent pancreatic cancer treated with first-line gemcitabine plus nab-paclitaxel: a single-center retrospective cohort study.
Article in Journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Prognostic stratification at the initiation of chemotherapy is clinically important in patients with metastatic or recurrent unresectable pancreatic cancer. The lactate dehydrogenase-to-albumin ratio (LAR) is an objective blood-based index that combines tumor-associated activities with systemic conditions of the host; however, evidence of its usefulness as a prognostic index in patients receiving first-line gemcitabine plus nab-paclitaxel (GnP) remains limited. In this study, we evaluated the prognostic value of baseline LAR in these patients. Methods: This single-center retrospective cohort study included consecutive patients with metastatic or recurrent unresectable pancreatic cancer who underwent first-line GnP between 2015 and 2024. Baseline LAR was calculated from laboratory data obtained within 7 days before treatment initiation, and neutrophil-to-lymphocyte ratio (NLR) was evaluated as a comparative inflammatory marker. The primary analysis evaluated the association between baseline LAR and overall survival (OS) using prespecified multivariable Cox proportional hazards models. The functional form of LAR was examined using restricted cubic splines (RCS). Kaplan-Meier curves were then presented to visualize risk stratification by combining Eastern Cooperative Oncology Group performance status (ECOG PS) with LAR. The incremental prognostic performance beyond the base clinical model was evaluated using model fit and discrimination metrics, with bootstrap internal validation. Results: The final analytic cohort comprised 205 patients (median age, 67 years; 63.9% men). The median baseline LAR was 4.94. In the prespecified multivariable model, ECOG PS and LAR were independently associated with OS [PS 2 Conclusions: Baseline LAR was independently associated with OS after adjustment for ECOG PS in patients receiving first-line GnP. Therefore, PS combined with LAR may enable simple prognostic stratification at treatment initiation, pending confirmation in future external validation cohorts.
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