The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer

<b>Background/Objectives:</b> Pancreatic cancer (PC) is an aggressive malignancy with a poor prognosis, frequently diagnosed at a metastatic stage. The identification of accessible, cost-effective prognostic biomarkers is critical for optimizing treatment strategies. The Endothelial Acti...

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Main Authors: Vahit Can Cavdar, Yalcin Gokmen, Mert Aric, Tugba Altunkaya, Cennet Gizem Erdem, Ilkay Gulturk, Cigdem Usul Afsar
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/14/1740
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author Vahit Can Cavdar
Yalcin Gokmen
Mert Aric
Tugba Altunkaya
Cennet Gizem Erdem
Ilkay Gulturk
Cigdem Usul Afsar
author_facet Vahit Can Cavdar
Yalcin Gokmen
Mert Aric
Tugba Altunkaya
Cennet Gizem Erdem
Ilkay Gulturk
Cigdem Usul Afsar
author_sort Vahit Can Cavdar
collection DOAJ
description <b>Background/Objectives:</b> Pancreatic cancer (PC) is an aggressive malignancy with a poor prognosis, frequently diagnosed at a metastatic stage. The identification of accessible, cost-effective prognostic biomarkers is critical for optimizing treatment strategies. The Endothelial Activation and Stress Index (EASIX), calculated using lactate dehydrogenase (LDH), creatinine, and platelet count, reflects endothelial dysfunction and has shown prognostic value in hematological cancers. However, its utility in metastatic PC remains unexplored. This study is the first to evaluate the prognostic significance of the EASIX in patients with metastatic PC receiving first-line FOLFIRINOX chemotherapy. <b>Methods:</b> This retrospective cohort study analyzed 204 patients diagnosed with metastatic pancreatic adenocarcinoma at Istanbul Training and Research Hospital between 2020 and 2025. All patients received FOLFIRINOX as first-line therapy. EASIX was calculated as LDH (U/L) × creatinine (mg/dL)/platelet count (10<sup>9</sup>/L). A cut-off value of 1.33 was used to stratify patients into low and high EASIX groups. Overall survival (OS) was assessed using Kaplan–Meier analysis and compared with the log-rank test. <b>Results:</b> The mean patient age was 63.0 ± 9.4 years; 61.8% were male. There were no significant differences in baseline characteristics between groups. Patients with EASIX ≥ 1.33 had significantly lower platelet counts and higher LDH and creatinine levels. Median OS was 14 months for EASIX < 1.33 and 8 months for EASIX ≥ 1.33 (<i>p</i> < 0.001). <b>Conclusions:</b> EASIX is a simple, inexpensive prognostic marker associated with overall survival in metastatic PC. Its integration into clinical practice may facilitate early risk stratification. Further prospective studies are needed to confirm its prognostic utility.
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spelling doaj-art-18eb4f93df814d62a764695a0c153faa2025-08-20T03:58:26ZengMDPI AGDiagnostics2075-44182025-07-011514174010.3390/diagnostics15141740The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic CancerVahit Can Cavdar0Yalcin Gokmen1Mert Aric2Tugba Altunkaya3Cennet Gizem Erdem4Ilkay Gulturk5Cigdem Usul Afsar6Department of Internal Medicine, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul 34098, TurkeyDepartment of Internal Medicine, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul 34098, TurkeyDepartment of Internal Medicine, Beylikduzu State Hospital, Istanbul 34500, TurkeyDepartment of Medical Oncology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul 34093, TurkeyDepartment of Medical Oncology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul 34093, TurkeyDepartment of Medical Oncology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul 34093, TurkeyDepartment of Medical Oncology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul 34093, Turkey<b>Background/Objectives:</b> Pancreatic cancer (PC) is an aggressive malignancy with a poor prognosis, frequently diagnosed at a metastatic stage. The identification of accessible, cost-effective prognostic biomarkers is critical for optimizing treatment strategies. The Endothelial Activation and Stress Index (EASIX), calculated using lactate dehydrogenase (LDH), creatinine, and platelet count, reflects endothelial dysfunction and has shown prognostic value in hematological cancers. However, its utility in metastatic PC remains unexplored. This study is the first to evaluate the prognostic significance of the EASIX in patients with metastatic PC receiving first-line FOLFIRINOX chemotherapy. <b>Methods:</b> This retrospective cohort study analyzed 204 patients diagnosed with metastatic pancreatic adenocarcinoma at Istanbul Training and Research Hospital between 2020 and 2025. All patients received FOLFIRINOX as first-line therapy. EASIX was calculated as LDH (U/L) × creatinine (mg/dL)/platelet count (10<sup>9</sup>/L). A cut-off value of 1.33 was used to stratify patients into low and high EASIX groups. Overall survival (OS) was assessed using Kaplan–Meier analysis and compared with the log-rank test. <b>Results:</b> The mean patient age was 63.0 ± 9.4 years; 61.8% were male. There were no significant differences in baseline characteristics between groups. Patients with EASIX ≥ 1.33 had significantly lower platelet counts and higher LDH and creatinine levels. Median OS was 14 months for EASIX < 1.33 and 8 months for EASIX ≥ 1.33 (<i>p</i> < 0.001). <b>Conclusions:</b> EASIX is a simple, inexpensive prognostic marker associated with overall survival in metastatic PC. Its integration into clinical practice may facilitate early risk stratification. Further prospective studies are needed to confirm its prognostic utility.https://www.mdpi.com/2075-4418/15/14/1740pancreatic cancerEndothelial Activation and Stress Index (EASIX)overall survival (OS)
spellingShingle Vahit Can Cavdar
Yalcin Gokmen
Mert Aric
Tugba Altunkaya
Cennet Gizem Erdem
Ilkay Gulturk
Cigdem Usul Afsar
The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer
Diagnostics
pancreatic cancer
Endothelial Activation and Stress Index (EASIX)
overall survival (OS)
title The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer
title_full The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer
title_fullStr The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer
title_full_unstemmed The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer
title_short The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer
title_sort prognostic value of the easix score in patients with metastatic pancreatic cancer
topic pancreatic cancer
Endothelial Activation and Stress Index (EASIX)
overall survival (OS)
url https://www.mdpi.com/2075-4418/15/14/1740
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