| セッション情報 | The 4th International ForumBest Short Oral Presentations（Pancreaticobiliary disorders） |
|---|---|
| タイトル | IFII-BSOP-2：Histopathologic and molecular prognostic biomarkers in patients with downstaged pancreatic cancer |
| 演者 | Donahue Timothy R.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA） |
| 共同演者 | Kadera Brian E.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Sunjaya Dharma B.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Isacoff William H.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Li Luyi（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Hines O. Joe（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Tomlinson James S.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Dawson David W.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Rochefort Matthew M.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Donald Graham W.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Clerkin Barbara M.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA）, Reber Howard A.（Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles（UCLA）, USA） |
| 抄録 | Objective：Treatment of patients with borderline resectable/locally advanced pancreatic cancer（BR/LA PC）is not standardized. The objective of this study was to identify histopathologic and molecular prognostic biomarkers in this patient subgroup. Methods：Retrospective analysis of patients from a single institution during 1992-2011 with BR/LA PC who were treated and surgically resected. Clinicopathologic variables；and SMAD4 and S100A2 protein, and microRNA-21 expression were correlated with survival by univariate and multivariate Cox proportional hazard modeling（MVA）. Results：All 49 patients were deemed initially unresectable due to vascular involvement. After completing preoperative chemotherapy for a median of 7.1 months（1.8-29.8）, a majority（75.5%）underwent a pylorus-preserving Whipple operation；3 patients（6.1%）had a vascular resection. The median overall survival（OS）was 40.1 months（11.8-213.1）. On univariate analysis, histopathologic（HP）variables correlated with OS included perineural invasion（HR 5.53, p=0.007）, grade（HR 3.68, p=0.02）and LN positivity（p=0.047）. The molecular biomarkers, SMAD4 loss（p=0.01）in tumor cells and microRNA-21 expression in the stroma（p=0.049）also correlated with OS. On MVA of HP and molecular markers, only SMAD4 loss was significant（HR 5.44, p=0.04）. To our knowledge, this is the first study to show a correlation of SMAD4 and microRNA-21 with survival in this patient subgroup. Conclusion：After surgical resection, PNI, grade, LN involvement, and microRNA-21 and SMAD4 status may help identify patients who would benefit from adjuvant therapy in this select subset of patients. Keywords：Pancreatic cancer, prognostic biomarkers, downstaging chemotherapy |
| 索引用語 |