Preoperative Total Iron‐Binding Capacity Is a Potential Surrogate Marker of Long‐Term Outcomes After Pancreatectomy for Pancreatic Cancer

ABSTRACT Background This study aimed to examine whether preoperative serum total iron‐binding capacity (TIBC), which is directly proportional to transferrin level, correlates with long‐term outcomes after pancreatectomy. Methods Preoperative TIBC levels, calculated by summing serum iron and unsaturated iron binding capacity, were evaluated in 158 patients who underwent pancreatectomy for pancreatic cancer. We defined TIBC < 258 μg/dL calculated by receiver‐operating characteristic (ROC) analysis as low TIBC. We evaluated the relationship between preoperative TIBC levels and long‐term outcomes after pancreatectomy. Results Low preoperative TIBC levels were correlated with lower body mass index, higher rate of preoperative chemotherapy, lower albumin, and higher amount of intraoperative blood loss compared to those in high TIBC levels ( p = 0.041, 0.046, 0.0002, 0.0032, respectively). Patients with low preoperative TIBC levels had significantly poorer overall survival (OS) and recurrence‐free survival (RFS) compared to that in high TIBC level in Kaplan–Meier analysis ( p < 0.0001, p = 0.0031). Furthermore, these patients were significantly correlated with worse OS and RFS in univariate and multivariate analyses (OS; hazard ratio [HR] 6.22, 95% confidence interval [CI] 1.770–21.838, p = 0.0044/RFS; HR 3.24, 95% CI 1.012–13.206, p = 0.048). Conclusion Preoperative low serum TIBC levels may be a potential surrogate marker of long‐term survival after pancreatectomy for pancreatic cancer.