title: Prognostic significance of DNA cytometry for adjuvant therapy response in pancreatic cancer.
abstract: OBJECTIVE
  The continuous progress in treatment options for pancreatic adenocarcinoma has lead to a re-evaluation of prognostic markers. In this study the prognostic relevance of DNA Index and classical histopathological parameters with regard to disease-free (DFS) and overall survival (OS) was analyzed within the CONKO-001 patient population.
  
  
  METHODS
  One hundred forty three fresh-frozen paraffin-embedded tissue samples of the resected tumor specimen of the CONKO-001 patient population were available for DNA index analysis to evaluate its impact on patient outcome.
  
  
  RESULTS
  Median DFS (7.3 vs. 14.3 months; P = 0.004) and median OS (16.6 vs. 29.2 months; P = 0.011) were significantly decreased in patients with a high DNA index (>1.4). Multivariate analysis revealed both DNA index (DFS: P = 0.002; OS: P = 0.019) and tumor grading (DFS: P = 0.004; OS: P = 0.004) as individual prognostic markers for DFS and OS. The following prognostic subgroups were identified: good (low DNA Index + G1/2 tumor grading), intermediate (low DNA Index + G3 tumor grading or high DNA Index + G1/2 tumor grading), poor (high DNA Index + G3 tumor grading).
  
  
  CONCLUSIONS
  The DNA index/tumor grading constellation may serve as a helpful guide for personalized treatment recommendations for adjuvant therapy of patients with pancreatic adenocarcinoma.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Fritz
authors.initials: F
authors.lastname: Klein
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Bahra
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Schirmeier
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Hussein
authors.initials: H
authors.lastname: Al-Abadi
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.affiliation: Department of Medical Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Pelzer
authors.affiliation: Department of Outpatient, Medical Oncology, Friedrichshafen, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Oettle
authors.affiliation: Department of Medical Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Striefler
authors.affiliation: Department of Medical Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Hanno
authors.initials: H
authors.lastname: Riess
authors.affiliation: Department of Medical Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Sinn
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D017024:Chemotherapy, Adjuvant; D004273:DNA, Neoplasm / Q000032:analysis* / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019044:Image Cytometry / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm
keywords: CONKO-001; DNA Index; adjuvant therapy; pancreatic adenocarcinoma; tumor grading