• Annals of surgery · Feb 2023

    The Impact of Molecular Subtyping on Pathological Staging of Pancreatic Cancer.

    • Stephan B Dreyer, Sarah Rae, Kirsty Bisset, Rosie Upstill-Goddard, Georgios Gemenetzis, Amber L Johns, Euan J Dickson, Anubhav Mittal, Anthony J Gill, Fraser Duthie, Antonio Pea, Rita T Lawlor, Aldo Scarpa, Roberto Salvia, Alessandra Pulvirenti, Alessandro Zerbi, Federica Marchesi, Colin J McKay, Andrew V Biankin, Jaswinder S Samra, David K Chang, Nigel B Jamieson, Australian Pancreatic Cancer Genome Initiative, and Glasgow Precision Oncology Laboratory.
    • Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow, Scotland, United Kingdom.
    • Ann. Surg. 2023 Feb 1; 277 (2): e396e405e396-e405.

    BackgroundThe long-term outcomes following surgical resection for pancreatic ductal adenocarcinoma (PDAC) remains poor, with only 20% of patients surviving 5 years after pancreatectomy. Patient selection for surgery remains suboptimal largely due to the absence of consideration of aggressive tumor biology.ObjectiveThe aim of this study was to evaluate traditional staging criteria for PDAC in the setting of molecular subtypes.MethodsClinicopathological data were obtained for 5 independent cohorts of consecutive unselected patients, totaling n = 1298, including n = 442 that underwent molecular subtyping. The main outcome measure was disease-specific survival following surgical resection for PDAC stratified according to the American Joint Commission for Cancer (TNM) staging criteria, margin status, and molecular subtype.ResultsTNM staging criteria and margin status confers prognostic value only in tumors with classical pancreatic subtype. Patients with tumors that are of squamous subtype, have a poor outcome irrespective of favorable traditional pathological staging [hazard ratio (HR) 1.54, 95% confidence interval (CI) 1.04-2.28, P = 0.032]. Margin status has no impact on survival in the squamous subtype (16.0 vs 12.1 months, P = 0.374). There were no differences in molecular subtype or gene expression of tumors with positive resection margin status.ConclusionsAggressive tumor biology as measured by molecular subtype predicts poor outcome following pancreatectomy for PDAC and should be utilized to inform patient selection for surgery.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.