Impact of Intratumoral Inflammation on Survival after Pancreatic Cancer Resection

Objectives Pancreatic cancer (PaC) frequently results in death despite surgical resection. We sought to evaluate whether inflammation in the primary tumor was associated with early death after surgical resection. Methods In this case-control study, we identified 21 individuals who died less than 12 months after surgery for PaC and 42 controls who survived more than 36 months after surgery. Differences in the composition of host inflammatory response between the groups were evaluated with univariate comparisons and odds ratios for early death were calculated using logistic regression modeling. Results Cases were more likely to have a high tumor grade (90.5% vs 26.2%; P < 0.01). The odds of early death were increased in those with a high-grade tumor (unadjusted odds ratio, 26.77; 95% confidence interval, 5.35-134.07; P < 0.01). Conversely, the density (high vs low) of inflammatory cells in tumors was similar between the groups, and odds of early death were not associated with any inflammatory marker. Conclusions High tumor grade, but not altered density of inflammatory cells in the intratumoral compartment, is associated with increased odds of early death after PaC resection. Future studies evaluating the host response in multiple tumor compartments with advanced histologic techniques is needed to further elucidate the role of inflammation in PaC.