Prognostic stratification of resected pancreatic ductal adenocarcinoma: Past, present, and future

Barhli, Aline; Cros, Jérôme; Bartholin, Laurent; Neuzillet, Cindy

doi:10.1016/j.dld.2018.08.009

Cited by 23 publications

(25 citation statements)

References 132 publications

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“…CA19-9 remains the only biomarker recommended for clinical use by the National Comprehensive Cancer Network (NCCN) guidelines for pancreatic cancer and it is recognized as the most clinically useful biomarker [58]; its sensitivity and specificity are 80% and 80-90% respectively [82], its level is strongly correlated with the tumor burden [83].…”

Section: Ca19-9mentioning

confidence: 99%

“…Despite its approval, it is far to be an ideal prognostic biomarker: it can yield false negative results in patients who do not express the Lewis blood antigen, accounting from 5% to 10% of general population [82], as it can give false positive results in case of pancreatitis, cholestasis, diabetes, cirrhosis or other cancers [82]. Many studies described the prognostic role of CA19-9 decline after curative surgery [84] and during chemotherapy [85,86], especially an early decrease during treatment has been supposed to foresee a longer PFS [87] in patients receiving gemcitabine-nabpaclitaxel and FOLFIRINOX.…”

Section: Ca19-9mentioning

confidence: 99%

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Prognostic and predictive factors in pancreatic cancer

et al. 2020

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Pancreatic cancer is one of the leading causes of cancer death worldwide. Its high mortality rate has remained unchanged for years. Radiotherapy and surgery are considered standard treatments in early and locally advanced stages. Chemotherapy is the only option for metastatic patients. Two treatment regimens, i. e. the association of 5-fluorouracil-irinotecan-oxaliplatin (FOLFIRINOX) and the association of nabpaclitaxel with gemcitabine, have been shown to improve outcomes for metastatic pancreatic adenocarcinoma patients. However, there are not standardized predictive biomarkers able to identify patients who benefit most from treatments. CA19-9 is the most studied prognostic biomarker, its predictive role remains unclear. Other clinical, histological and molecular biomarkers are emerging in prognostic and predictive settings. The aim of this review is to provide an overview of prognostic and predictive markers used in clinical practice and to explore the most promising fields of research in terms of treatment selection and tailored therapy in pancreatic cancer.

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Section: Ca19-9mentioning

confidence: 99%

Section: Ca19-9mentioning

confidence: 99%

Prognostic and predictive factors in pancreatic cancer

et al. 2020

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“…However, even patients that are staged with a locally, resectable tumor, may already have micro-metastasis at the time of diagnosis and recurrence within the first year of surgery is common [3]. Tumor size, lymph node involvement, grade and margin status are important prognostic factors, but are insufficient to predict early disease recurrence and survival after surgical resection [4]. No biomarker is yet available to help guide prognosis and treatment selection in pancreatic cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Galectin 4 is a biomarker for early recurrence and death after surgical resection for pancreatic ductal adenocarcinoma

Ansari

Zhou

et al. 2019

Scandinavian Journal of Gastroenterology

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Background: Galectins are a group of carbohydrate-binding proteins that are involved in neoplastic development and progression. In a previous mass spectrometry-based study, we identified galectin 4 as a down-regulated protein in short-term survivors of pancreatic cancer. This study was performed to validate the prognostic value of galectin 4 in a larger cohort of pancreatic cancer patients undergoing surgical resection. Methods: Galectin 4 expression was evaluated by tissue microarrays and immunohistochemistry in 140 patients with surgically resected pancreatic cancer. Kaplan-Meier and Cox proportional hazards modeling were used to explore the association between galectin 4 and survival. Results: Galectin 4 staining expression was positive in 111 cases (79.3%). The expression of galectin 4 was significantly associated with tumor size (p ¼ .008) and differentiation (p ¼ .001). Galectin 4 expression was significantly correlated with disease recurrence within 1 year of surgery (adjusted HR 0.485, p ¼ .027). There was also a significant association between galectin 4 and overall survival at 1 year (adjusted HR 0.482, p ¼ .047) and at 3 years (adjusted HR 0.550, p ¼ .025). Conclusion: Galectin 4 expression is a novel biomarker for early recurrence and mortality after surgical resection for pancreatic cancer.

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“…The AJCC TNM staging system is currently the most extensively used system to predict the prognosis of several types of cancer, including pancreatic adenocarcinoma (30). Numerous studies suggested that T and N stages might not be the only clinical factors that can be used to determine the prognosis of patients with pancreatic adenocarcinoma (9,13,14,31). Since implementing the traditional TNM staging system for patients with resected pancreatic adenocarcinoma is considered as imprecise, it is therefore essential to develop a more accurate survival predictive model (13,14,31,32).…”

Section: Discussionmentioning

confidence: 99%

“…However, the current TNM staging system for pancreatic adenocarcinoma does not include certain clinicopathological factors that may affect the prognosis, including age, sex, tumor grade and carbohydrate antigen 199 (CA199) level (11)(12)(13). CA199, as a measure of tumor burden, is a diagnostic and prognostic marker (14,15). Humphris et al (16) reported that normal preoperative CA199 levels identified a good prognosis.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a novel nomogram for predicting the prognosis of patients with resected pancreatic adenocarcinoma

Ren

Aimaiti

et al. 2020

Oncol Lett

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The survival prediction for patients with resected pancreatic adenocarcinoma by using the Tumor-Node-Metastasis (TNM) staging system remains limited. A nomogram is a efficient tool that can be used to predict the outcome of patients with various types of malignancy. The present study aimed to develop and validate a nomogram for patients with resected pancreatic adenocarcinoma. A total of 368 patients (258 in the training set and 110 in the validation set) who underwent pancreatic adenocarcinoma resection at the China National Cancer Center between January 2008 and October 2018 were included in the present study. The nomogram was established according to the results from Cox multivariate analysis, which was validated by discrimination and calibration. The area under the receiver operating characteristic curve (AUC) was determined to assess the accuracy of survival predictions. The results from multivariate analysis in the training set demonstrated that blood transfusion, T-stage, N-stage, tumor grade, capsule invasion, carbohydrate antigen 199, neutrophil percentage and adjuvant therapy were independent prognostic factors for overall survival (OS; all P<0.05). Subsequently, a nomogram predicting the 1-year, 3-year and 5-year OS rates, with favorable calibration, was established based on the independent prognostic factors. The concordance indices of the nomogram were higher compared with the TNM staging system in both training and validation sets. Furthermore, a clear risk stratification system based on the nomogram was used to classify patients into the three following groups: Low-risk group (≤168), moderate-risk group (168-255) and high-risk group (>255). The risk stratification system demonstrated an improved ability in predicting the 1-year, 3-year and 5-year OS rates compared with the TNM system (AUC, 0.758, 0.709 and 0.672 vs. AUC, 0.614, 0.604 and 0.568; all P<0.05). The present study developed and validated a nomogram for patients with resected pancreatic adenocarcinoma by including additional independent prognostic factors, including tumor marker, immune index, surgical information, pathological data and adjuvant therapy. Taken together, the results from the present study indicated an improved performance of the nomogram in predicting the prognosis of patients with resected pancreatic adenocarcinoma compared with the TNM staging system.

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Prognostic stratification of resected pancreatic ductal adenocarcinoma: Past, present, and future

Cited by 23 publications

References 132 publications

Prognostic and predictive factors in pancreatic cancer

Prognostic and predictive factors in pancreatic cancer

Galectin 4 is a biomarker for early recurrence and death after surgical resection for pancreatic ductal adenocarcinoma

Development and validation of a novel nomogram for predicting the prognosis of patients with resected pancreatic adenocarcinoma

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