***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The mechanisms of paraneoplastic thrombocytosis in ovarian cancer and the role that platelets play in abetting cancer growth are unclear . METHODS We analyzed clinical data on 619 patients with epithelial ovarian cancer to test associations between platelet counts and disease outcome . Human sample s and mouse models of epithelial ovarian cancer were used to explore the underlying mechanisms of paraneoplastic thrombocytosis . The effects of platelets on tumor growth and angiogenesis were ascertained . RESULTS Thrombocytosis was significantly associated with advanced disease and shortened survival . Plasma levels of thrombopoietin and interleukin-6 were significantly elevated in patients who had thrombocytosis as compared with those who did not . In mouse models , increased hepatic thrombopoietin synthesis in response to tumor-derived interleukin-6 was an underlying mechanism of paraneoplastic thrombocytosis . Tumor-derived interleukin-6 and hepatic thrombopoietin were also linked to thrombocytosis in patients . Silencing thrombopoietin and interleukin-6 abrogated thrombocytosis in tumor-bearing mice . Anti-interleukin-6 antibody treatment significantly reduced platelet counts in tumor-bearing mice and in patients with epithelial ovarian cancer . In addition , neutralizing interleukin-6 significantly enhanced the therapeutic efficacy of paclitaxel in mouse models of epithelial ovarian cancer . The use of an antiplatelet antibody to halve platelet counts in tumor-bearing mice significantly reduced tumor growth and angiogenesis . CONCLUSIONS These findings support the existence of a paracrine circuit wherein increased production of thrombopoietic cytokines in tumor and host tissue leads to paraneoplastic thrombocytosis , which fuels tumor growth . We speculate that countering paraneoplastic thrombocytosis either directly or indirectly by targeting these cytokines may have therapeutic potential . ( Funded by the National Cancer Institute and others . ) Background : Inflammation-based prognostic scores including the  Glasgow Prognostic Score ( GPS )  ,  neutrophil to lymphocyte ratio ( NLR ) , and  Prognostic Nutritional Index ( PNI ) are associated with survival in patients with hepatocellular carcinoma ( HCC ) . The aim of this study was to investigate the prognostic value of these inflammation-based prognostic scores in patients with HCC . Methods : In total , 150 patients with newly diagnosed HCC were prospect ively evaluated . Patients were divided according to the GPS , modified GPS , NLR , platelet to lymphocyte ratio ( PLR ) , Prognostic Index ( PI ) , and PNI . The area under the receiver operating characteristics curve ( AUC ) was calculated to compare the predictive ability of each of the scoring systems . A univariate and multivariate analysis were performed to identify the clinicopathological variables associated with overall survival . Results : The GPS consistently had a higher AUC value at 6 months ( 0.768 ) , 12 months ( 0.787 ) , and 24 months ( 0.758 ) in comparison with other inflammation-based prognostic scores . A multivariate analysis showed that the GPS was independently associated with overall survival . Conclusion : This study demonstrates that the GPS , an inflammation-based prognostic score , is an independent marker of poor prognosis in patients with HCC and is superior to the other inflammation-based prognostic scores in terms of prognostic ability Background : The host inflammatory response has a vital role in carcinogenesis and tumour progression . We examined the prognostic value of  inflammatory markers ( albumin , white-cell count and its components , and platelets )  in pre-treated patients with advanced renal cell carcinoma ( RCC ) . Methods : Using data from a r and omised trial , multivariable proportional hazards models were generated to examine the impact of inflammatory markers and established prognostic factors ( performance status , calcium , and haemoglobin ) on overall survival ( OS ) . We evaluated a new prognostic classification incorporating additional information from inflammatory markers . Results : Of the 416 patients , 362 were included in the analysis .  Elevated neutrophil counts , elevated platelet counts , and a high neutrophil – lymphocyte ratio were significant independent predictors for shorter OS in a model with established prognostic factors . The addition of inflammatory markers improves the discriminatory value of the prognostic classification as compared with established factors alone ( C-statistic 0.673 vs 0.654 , P=0.002 for the difference ) , with 25.8 % ( P=0.004 ) of patients more appropriately classified using the new classification . Conclusion : Markers of systemic inflammation contribute significantly to prognostic classification in addition to established factors for pre-treated patients with advanced RCC . Upon validation of these data in independent studies , stratification of patients using these markers in future clinical trials is recommended BACKGROUND The objective of this study was to investigate whether the preoperative platelet-lymphocyte ( P/L ) ratio represents a significant prognostic index in resected pancreatic ductal adenocarcinoma . METHODS A total of 110 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a prospect ively maintained data base . RESULTS The preoperative P/L ratio was found to be a more significant prognostic marker ( P < .001 ) than either the lymphocyte count ( P = .007 ) or platelet count ( P = .068 ) on univariate Cox survival analysis . The median overall survival in patients with a P/L ratio of 150 or less ( n = 48 ) was 19.7 months , 13.7 months in those with a P/L ratio of 151 to 300 ( n = 43 ) , and 5.8 months in patients with a value of greater than 300 ( n = 19 ) ( log-rank , P = .006 ) . The preoperative P/L ratio retained significance on multivariate analysis ( P < .001 ) , along with tumor size ( P = .010 ) and lymph node ratio ( P = .013 ) . CONCLUSIONS The preoperative P/L ratio represents a significant independent prognostic index in patients of resected pancreatic adenocarcinoma Background / Aims : To identify potential preoperative prognostic factors in resected pancreatic and periampullary neuroendocrine tumours . Methods : Clinico-pathological data for 54 consecutive patients with pancreatic or periampullary neuroendocrine tumours referred to our institution over a 10-year period were identified from a prospect i ve data base . Results : 34 patients underwent pancreatic resection ( 12 males , 22 females ; median age 54 ( IQR 44–71 ) years ) . There was a single 30-day mortality ( 3 % ) . Nodal status ( log rank , p = 0.652 ) , microscopic resection margin involvement ( p = 0.549 ) and tumour size ( p = 0.122 ) failed to exhibit any prognostic value . Only the presence of malignant tumour characteristics was associated with poorer overall survival ( p = 0.008 ) . Analysis of preoperative parameters showed that age > 60 years ( p = 0.056 ) , platelet-lymphocyte ratio > 300 ( p = 0.008 ) , alkaline phosphatase levels > 125 U/l ( p = 0.042 ) and alanine aminotransferase > 35 U/l ( p = 0.016 ) were adverse prognostic factors . A risk stratification score was generated where each adverse preoperative parameter was allocated a score of 1 . A cumulative score of ≤1 was defined as low risk , while a score of ≥2 was defined as high risk . Median overall survival in the high-risk group was 10.4 months , while the median survival in the low-risk group was > 60 months ( p < 0.001 ) . Conclusion : Significant prognostic information can be gained from routine preoperative biochemistry and haematology results in resected pancreatic and periampullary neuroendocrine tumours . These findings merit further evaluation in a larger patient cohort Background The objective of this study was to evaluate whether preoperative CA19 - 9 levels and the platelet – lymphocyte ratio ( PLR ) might reflect prognostic indices for resected ampullary adenocarcinoma . Material s and Methods Data were collected prospect ively over a 10-year period for consecutive patients undergoing pancreatoduodenectomy for malignancy . Results Both preoperative PLR and CA19 - 9 results were available in 52 cases of resected ampullary adenocarcinoma .  Preoperative CA19 - 9 levels of ≤150 kU/l ( or ≤300 kU/l in the presence of bilirubin levels > 35 µmol/l ) and a PLR of ≤160 were found to represent the optimal cut-off values to risk stratify patients . If both levels were elevated ( n = 8) , patients had a median overall survival of 10.1 months . If either CA19 - 9 or PLR were elevated individually ( n = 23 ) , patients had a median survival of 25.2 months . For cases where both levels were less than the cut-off values ( n = 21 ) , the median overall survival time was not reached but was greater than 60 months ( log rank , p < 0.001 ) . This preoperative risk stratification was found to remain a significant independent predictor of survival on multivariate analysis ( Cox , p = 0.001 ) alongside resection margin status ( p = 0.002 ) and tumor size ( p = 0.051 ) . Conclusions Preoperative CA19 - 9 and PLR both merit further evaluation as prognostic indices in resected ampullary adenocarcinoma 
    Output:
    
A high PLR is associated with worse OS in various solid tumors .
IMPACT PLR is a readily available and inexpensive biomarker with independent prognostic value in solid tumors