The role of flow cytometric DNA analysis in determining prognosis of resectable ductal adenocarcinoma of the pancreas.
Carcinoma of the pancreas is a leading cause of cancer mortality in the United States. Improvement in prediction of survival is needed. Flow cytometric analysis as a prognostic tool has produced conflicting results. We retrospectively analyzed the clinicopathologic features, operative factors, and outcome of 39 curative resections for ductal adenocarcinoma of the head of the pancreas performed at Indiana University Medical Center between 1989 and 1994. The group was composed of 20 females and 19 males. Procedures performed were Whipple without vagotomy (n = 5), Whipple with vagotomy (n = 19), pylorus-preserving Whipple (n = 12) and total pancreatectomy (n = 3). Thirty-two tumors were suitable for DNA analysis. Of the 32 patients with flow cytometric data, 33 per cent (3/9) of living patients and 39 per cent (9/23) of deceased patients had aneuploid tumors (P = 0.999). The average S-phase for living patients was 8.3 per cent +/- 3.8 per cent, and 16.1 per cent +/- 13.6 per cent for deceased patients (P = 0.115). In the multivariate analysis, only lymphatic invasion (P = 0.015) and alkaline phosphatase level (P = 0.024) predicted poor survival. Our data show no correlation between flow cytometric DNA ploidy, S-phase analysis, and prognosis in patients undergoing curative resection for ductal adenocarcinoma of the pancreatic head.
Park
C S
CS
Department of Surgery, Indiana University School of Medicine, Indianapolis, USA.
Wiebke
E A
EA
Sidner
R A
RA
Miller
G A
GA
Cummings
O W
OW
Howard
T J
TJ
Fineberg
N S
NS
Madura
J A
JA
D000230:Adenocarcinoma / Q000235:genetics* / Q000401:mortality / Q000601:surgery*; D000782:Aneuploidy; D004273:DNA, Neoplasm / Q000032:analysis*; D005434:Flow Cytometry; D006801:Humans; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000235:genetics* / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D012189:Retrospective Studies; D016196:S Phase; D015996:Survival Rate
D004273:DNA, Neoplasm