Akademik Veri Yönetim Sistemi
JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES, cilt.9, sa.3, ss.612-618, 2025 (ESCI)
Purpose: Pancreatic ductal adenocarcinoma (PDAC) is still associated with an extremely poor prognosis despite advances in treatment. The systemic inflammatory response index (SIRI), which combines neutrophils, monocytes, and lymphocytes, has emerged as a prognostic biomarker in various cancers. However, its role in resectable PDAC remains unclear. Materials and Methods: This retrospective study analyzed 82 patients who underwent curative-intent surgery for PDAC between 2011 and 2021. Preoperative SIRI was calculated as (neutrophils x monocytes) / lymphocytes using blood counts obtained within one week before surgery. The optimal SIRI cut-off for overall survival (OS) prediction was determined using ROC analysis. Survival outcomes were assessed via Kaplan-Meier curves and Cox regression models. Results: The optimal SIRI cut-off was 1.36 (AUC: 0.738). Patients with SIRI <= 1.36 had significantly longer OS than those with SIRI >1.36 (31 vs. 20 months, p=0.04), including among early-stage patients. In multivariate analysis, SIRI >1.36 remained an independent predictor of poor OS (HR: 1.87, 95% CI: 1.08-3.21, p=0.023), along with age, ECOG status, and disease stage. Conclusion: Preoperative SIRI is an independent prognostic marker in resectable PDAC and could assist in recognizing high-risk patients who could benefit from intensified follow-up or additional therapeutic strategies. Prospective multicenter studies are warranted to validate these findings and integrate SIRI into clinical risk models.