• José Annelie Suurmeijer, Eline Christine Soer, Mark Pui Gien Dings, Yongsoo Kim, Marin Strijker, Bert Anne Bonsing, Lodewijk Adriaan Anton Brosens, Olivier Robert Busch, Jesse Vincent Groen, Johannes Berend Gerardus Halfwerk, Robbert Alexander Eduard Slooff, Hanneke Wilma Marlies van Laarhoven, Isaac Quintus Molenaar, George Johan Arnold Offerhaus, Johannes Morreau, Marc Jone van de Vijver, Arantza Fariña Sarasqueta, Joanne Verheij, Marc Gerard Besselink, Maarten Fokke Bijlsma, Frederike Dijk, and Dutch Pancreatic Cancer Group .
• Department of Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands.
• Br J Surg. 2022 Oct 14; 109 (11): 115011551150-1155.

BackgroundThe recently identified classical and basal-like molecular subtypes of pancreatic cancer impact on overall survival (OS). However, the added value of routine subtyping in both clinical practice and randomized trials is still unclear, as most studies do not consider clinicopathological parameters. This study examined the clinical prognostic value of molecular subtyping in patients with resected pancreatic cancer.MethodsSubtypes were determined on fresh-frozen resected pancreatic cancer samples from three Dutch centres using the Purity Independent Subtyping of Tumours classification. Patient, treatment, and histopathological variables were compared between subtypes. The prognostic value of subtyping in (simulated) pre- and postoperative settings was assessed using Kaplan-Meier and Cox regression analyses.ResultsOf 199 patients with resected pancreatic cancer, 164 (82.4 per cent) were classified as the classical and 35 (17.6 per cent) as the basal-like subtype. Patients with a basal-like subtype had worse OS (11 versus 16 months (HR 1.49, 95 per cent c.i. 1.03 to 2.15; P = 0.035)) than patients with a classical subtype. In multivariable Cox regression analysis, including only clinical variables, the basal-like subtype was a statistically significant predictor for poor OS (HR 1.61, 95 per cent c.i. 1.11 to 2.34; P = 0.013). When histopathological variables were added to this model, the prognostic value of subtyping decreased (HR 1.49, 95 per cent c.i. 1.01 to 2.19; P = 0.045).ConclusionThe basal-like subtype was associated with worse OS in patients with resected pancreatic cancer. Adding molecular classification to inform on tumor biology may be used in patient stratification.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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