Li S, et al. - A novel ratio index based on preoperative liver function test, γ-glutamyltransferase-to-albumin ratio (GAR) was created and was assessed for prognostic significance in predicting clinical outcomes of pancreatic ductal adenocarcinoma (PDAC) patients after radical surgery. Researchers retrospectively enrolled 833 PDAC patients who had radical surgery at their institution between January 2010 and January 2017 and divided them into two groups according to the cut-off value of GAR. They generated a more accurate prognostic model combining TNM stage, GAR (optimal cut-off value 0.65), preoperative serum carbohydrate antigen 19-9 (CA19-9) and tumor differentiation. Outcomes revealed the independent predictive value of a high level of GAR for poorer postoperative overall survival and recurrence-free survival. As per subgroup analysis, GAR was predictive of survival in patients without biliary obstruction or severely impaired liver function.