Clinicopathologic Evaluation After Resection for Ductal Adenocarcinoma of the Pancreas: A Retrospective, Single-Institution Experience

Takai, Soichiro; Satoi, Sohei; Toyokawa, Hideyoshi; Yanagimoto, Hiroaki; Sugimoto, Naotoshi; Tsuji, Kazuyuki; Araki, Hiroshi; Matsui, Yoshihiko; Imamura, Atsushi; Ah, Kwon; Kamiyama, Yasuo

doi:10.1097/00006676-200304000-00007

Cited by 93 publications

(56 citation statements)

References 18 publications

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“…ROC curve analysis revealed that CA 19-9 level of more than 106 U/ml was linked to 2 year survival with 79.3% sensitivity and 74.5% specificity. Twelve month survival and survival to hospital discharge could not be predicted by CA 19-9 level (Tables 1, 2, 3). CA 19-9 level, both as a continuous variable and dichotomized, as at least 106 U/ml or more than 106 U/ml, was an independent predictor of overall survival, 2 year survival but it was not related to perioperative death (Table 4- 11). Survival analysis during the first 12 months showed that the higher level of CA 19-9 was linked to the higher risk of death in the whole analyzed group, but such a relationship could not be detected when the subgroup of patients who died during the perioperative period was excluded (Table 7-12).…”

Section: Serum Ca 19-9 Levelmentioning

confidence: 99%

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Rudnicki

Agrawal²,

Grzebieniak³

et al. 2010

Folia Histochem Cytobiol.

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Abstract:The prognosis in patients with pancreatic cancer is poor and some authors describe it as a lethal disease. At the time of diagnosis only 14% of patients could be surgically treated and up to 30% of them die within 12 months. Therefore, further clinical investigations on preoperative patient qualification are needed. A total of 81 patients were included into the study. The CA 19-9 concentration was measured before surgery by an automated, commercially available enzyme immunoassay in Axsym analyzer (Abott Diagnostics Laboratory). A value of 37 U/ml was used as the upper limit of normal levels. Tumors were staged according to the Union Against Cancer (UICC) of 2004 and graded during the histological evaluation according to the G0-G4 scale. All patients were monitored every three month via outpatient clinic visits. In the case of missing visit we contacted the families to establish the cause. We assessed perioperative, 12 month, 2 year and 5 year survival. Twelve moth, 2 year and 5 year survival were assessed in the whole studied population and in the group of patients with the exception of these who died during the perioperative period. The total five year survival was 6%. The median time of survival was 467 days (range: 163 -586 days). The perioperative period was survived by 91.4% patients, 12 months were survived by 71.6% patients, 2 years were survived by 35.8% patients, 5 years were survived by 6.2% patients. The serum Ca 19-9 level was above the normal limit in 80.5% patients. ROC curve analysis revealed that CA 19-9 level of more than 106 U/ml was linked to 2 year survival with 79.3% sensitivity and 74.5% specificity. Preoperative level of CA 19-9 below 106U/ml represents a predictive factor of 2-and 5-year survival, independent of other factors, such as lower size of the tumor, absence of metastases to lymph nodes, female gender of patients.After exclusion of the patients who died in the perioperative period, no relationship could have been disclosed between preoperative CA 19-9 levels and one year survival. The observation points to the chance that patients with higher levels of CA 19-9 harbour micrometastases, the development of which is sufficiently slow to allow for a one-year survival of the patients but which increase the risk of death after two and five years

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Section: Serum Ca 19-9 Levelmentioning

confidence: 99%

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Rudnicki

Agrawal²,

Grzebieniak³

et al. 2010

Folia Histochem Cytobiol.

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“…(13)(14)(15)(16)(17)(18)(19)(20) However, their prognostic value has been a matter of controversy because the studies were based on relatively small numbers of IDC patients. Hypoxia in pancreatic cancer has been reported to increase its malignant potential.…”

mentioning

confidence: 99%

Autophagy is activated in pancreatic cancer cells and correlates with poor patient outcome

et al. 2008

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Because autonomous proliferating cancer cells are often exposed to hypoxic conditions, there must be an alternative metabolic pathway, such as autophagy, that allows them to obtain energy when both oxygen and glucose are depleted. We previously reported finding that autophagy actually contributes to cancer cell survival in colorectal cancers both in vitro and in vivo. Pancreatic cancer remains a devastating and poorly understood malignancy, and hypoxia in pancreatic cancers is known to increase their malignant potential. In the present study archival pancreatic cancer tissue was retrieved from 71 cases treated by curative pancreaticoduodenectomy. Autophagy was evaluated by immunohistochemical staining with anti-LC3 antibody, as LC3 is a key component of autophagy and has been used as a marker of autophagy. The results showed that strong LC3 expression in the peripheral area of pancreatic cancer tissue was correlated with a poor outcome (P = 0.0170) and short disease-free period (P = 0.0118). Two of the most significant correlations among the clinicopathological factors tested were found between the peripheral intensity level of LC3 expression and tumor size (P = 0.0098) or tumor necrosis (P = 0.0127). Activated autophagy is associated with pancreatic cancer cells, and autophagy is thought to be a response to factors in the cancer microenvironment, such as hypoxia and poor nutrient supply. This is the first study to report the clinicopathological significance of autophagy in pancreatic cancer. (Cancer Sci 2008; 99: 1813-1819) C ancers are abnormal tissue masses whose growth exceeds and is uncoordinated with that of adjacent normal tissues, and which persist in the same excessive manner after cessation of the stimulus that evoked them.(1) All cancers ultimately depend on the host for their nutrition and blood supply, but as the preexisting vasculature is obviously insufficient to support the cancers' unlimited requirements for energy and nutrition as a result of their unregulated growth, angiogenesis has been considered pivotal to providing proliferating cancer cells with an adequate source of oxygen, energy, and nutrients. However, recent studies have revealed that even after new blood vessels have formed, both the oxygen and glucose supply is insufficient for the aggressively proliferating cancer cells in locally advanced cancers.(2-4) Tumor hypoxia has been used as a marker of poor prognosis; (5,6) however, how cancer cells become more malignant or survive with an extremely poor blood supply, as for example in pancreatic cancer, is poorly understood.(7) When cancer cells are exposed to hypoxia, anaerobic glycolysis increases and provides energy for cell survival, but as the glucose supply is also insufficient because of the poor blood supply, there must be an alternative metabolic pathway that provides energy when both oxygen and glucose are depleted. (8,9) We have reported that several cancer cell lines, including pancreatic cancer-and colorectal cancer-derived cell lines, are resistant to nutrient-deprived co...

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“…However, these improvements do not necessarily correlate with long-term postoperative survival, probably due to the heterogeneity of the clinic-pathologic characteristics of pancreatic cancer [19].…”

Section: Discussionmentioning

confidence: 98%

Pre-Operative and Operative Predictors of Survival of Resectable Cancer Head of Pancreas: A Retrospective Study

Fakhry¹

2015

JCTR

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Abstract:Background: Pancreatic adenocarcinoma (PAC) is one of the most fatal human malignancies and complete surgical resection is the only treatment that offers a hope for prolonged survival. However, even after curative resection, the overall 5-year survival rate is only 10%-29%. Aim: we aimed to examine the preoperative and operative predictors for survival following radical resection of PAC. Methods: Twenty-four patients with ductal adenocarcinoma of the head of pancreas who had undergone pancreatoduodenectomy at South Egypt Cancer Institute, Assiut University, between January 2010 and December 2011, were recruited. Results: The follow-up time ranged from 2 to 36 months with a median of 14 months. Univariate analysis revealed that anorexia, weight loss, pre-operative anaemia, hypoalbuminemia, obstructive jaundice, preoperative transfusions, WHO performance scale, presence of preoperative morbidities and tumor size were associated with the patients survival. Of the previous factors, pre-operative hemoglobin level (<10mg/dl), pre-operative serum albumin level (<30mg/dl), pre-operative transfusions (blood and albumin), and tumor size were found to influence the overall survival on the multivariate Cox Hazard Regression analysis. Conclusion: The current study concluded that preoperative malnutrition (due to anorexia, anaemia, hypoalbumineamia and preoperative transfusions) and large tumor size (>T2) were associated with poor outcome after surgical resection.

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Clinicopathologic Evaluation After Resection for Ductal Adenocarcinoma of the Pancreas: A Retrospective, Single-Institution Experience

Abstract: The prognosis after surgical resection of pancreatic carcinoma mostly depends on tumor factors. In this study, it was difficult to identify the determinants of long-term survival in patients with resectable tumors.

Cited by 93 publications

References 18 publications

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Autophagy is activated in pancreatic cancer cells and correlates with poor patient outcome

Pre-Operative and Operative Predictors of Survival of Resectable Cancer Head of Pancreas: A Retrospective Study

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