Li S, et al. - In 833 pancreatic ductal adenocarcinoma (PDAC) patients who had undergone radical surgery between January 2010 and January 2017, researchers assessed the prognostic value of a novel ratio index, developed by them, based on preoperative liver function test, γ-glutamyltransferase-to-albumin ratio (GAR), for predicting clinical outcomes. The optimal cut-off value of GAR was 0.65. Poorer postoperative overall survival (OS) and recurrence-free survival (RFS) were independently predicted by a high level of GAR. In patients without biliary obstruction or severely impaired liver function, survival prediction was enabled by GAR. Enhanced prognostic accuracy was obtained with the integration of GAR, preoperative serum carbohydrate antigen 19-9 (CA19-9), and tumor differentiation into TNM staging system.