title: Methylation of MGMT Is Associated with Poor Prognosis in Patients with Stage III Duodenal Adenocarcinoma.
abstract: BACKGROUND
  O6-methylguanine-DNA methyltransferase (MGMT) methylation status has not been extensively investigated in duodenal adenocarcinoma (DA). The aim of this study was to evaluate the MGMT methylation status and examine its possible prognostic value in patients with stage III DA.
  
  
  METHODS
  Demographics, tumor characteristics and survival were available for 64 patients with stage III DA. MGMT methylation was detected by using MethyLight. A Cox proportional hazard model was built to predict survival, adjusted for clinicopathological characteristics and tumor molecular features, including the CpG island methylator phenotype (CIMP), microsatellite instability (MSI), and KRAS mutations.
  
  
  RESULTS
  MGMT methylation was detected in 17 of 64 (26.6%) patients, and was not correlated with sex, age, tumor differentiation, CIMP, MSI, or KRAS mutations. MGMT methylation was the only one factor associated with both overall survival (OS) and disease-free survival (DFS) on both univariate and multivariate analyses. In patients treated with surgery alone, MGMT-methylated group had worse OS and DFS when compared with MGMT-unmethylated group. However, in patients treated with chemotherapy/radiotherapy, outcomes became comparable between the two groups.
  
  
  CONCLUSIONS
  Our results demonstrate MGMT methylation is a reliable and independent prognostic factor in DAs. Methylation of MGMT is associated with poor prognosis in patients with stage III DAs.
authors.affiliation: Department of Gastrointestinal Surgery II, Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital, Wuhan University, Wuhan, China.
authors.forename: Tao
authors.identifier: http://orcid.org/0000-0003-4713-7269
authors.initials: T
authors.lastname: Fu
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Anup
authors.initials: A
authors.lastname: Sharmab
authors.affiliation: Department of Gastrointestinal Surgery II, Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital, Wuhan University, Wuhan, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Xie
authors.affiliation: Department of Gastrointestinal Surgery II, Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital, Wuhan University, Wuhan, China.
authors.forename: Yanliang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Gastrointestinal Surgery II, Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital, Wuhan University, Wuhan, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery II, Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital, Wuhan University, Wuhan, China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wan
authors.affiliation: Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Baylin
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Wolfgang
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.|Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.|Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Nita
authors.initials: N
authors.lastname: Ahuja
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000201:enzymology / Q000473:pathology*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D059248:Chemoradiotherapy; D019175:DNA Methylation; D004379:Duodenal Neoplasms / Q000201:enzymology / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019853:O(6)-Methylguanine-DNA Methyltransferase / Q000235:genetics*; D011379:Prognosis
chemical_list: D000970:Antineoplastic Agents; D019853:O(6)-Methylguanine-DNA Methyltransferase