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The Impact of Molecular Subtyping on Pathological Staging of Pancreatic Cancer.
- Source :
- Annals of Surgery; Feb2023, Vol. 277 Issue 2, pe396-e405, 10p
- Publication Year :
- 2023
-
Abstract
- Background: The 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. Objective: The aim of this study was to evaluate traditional staging criteria for PDAC in the setting of molecular subtypes. Methods: Clinicopathological 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. Results: TNM 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. Conclusions: Aggressive tumor biology as measured by molecular subtype predicts poor outcome following pancreatectomy for PDAC and should be utilized to inform patient selection for surgery. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00034932
- Volume :
- 277
- Issue :
- 2
- Database :
- Supplemental Index
- Journal :
- Annals of Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 161230554
- Full Text :
- https://doi.org/10.1097/SLA.0000000000005050