Can we predict long-term survival in resectable pancreatic ductal adenocarcinoma?
File(s)oncotarget paper.pdf (816.48 KB)
Published version
Author(s)
Type
Journal Article
Abstract
Objective: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive tumour associated with poor 5-year survival. We aimed to determine factors which differentiate short and long-term survivors and identify a prognostic biomarker. Methods: Over a ten-year period, patients with resected PDAC who developed disease recurrence within 12 months (Group I) and those who had no disease recurrence for 24 months (Group II) were identified. Clinicopathological data was analysed. Ion Torrent high-throughput sequencing on DNA extracted from FFPE tumour samples was used to identify mutations. Additionally, peripheral blood samples were analysed for variants in cell-free DNA, circulating tumour cells (CTCs), and microRNAs. Results: Multivariable analysis of clinicopathological factors showed that a positive medial resection margin was significantly associated with short disease-free survival (p = 0.007). Group I patients (n = 21) had a higher frequency of the KRAS mutant mean variant allele (16.93% ± 11.04) compared to those in Group II (n = 13; 7.55% ± 5.76, p = 0.0078). Group I patients also trended towards having a KRAS c.35G>A p.Gly12Asp mutation in addition to variants in other genes, such as TP53, CDKN2A, and SMAD4. Mutational status of cell-free DNA, and number of CTCs, was not found to be useful in this study. A circulating miRNA (hsa-miR-548ah-5p) was found to be significantly differentially expressed. Conclusions: Medial resection margin status and the frequency of KRAS mutation in the tumour tissue are independent prognostic indicators for resectable PDAC. Circulating miRNA hsa-miR-548ah-5p has the potential to be used as a prognostic biomarker.
Date Issued
2019-01-22
Date Acceptance
2018-12-12
Citation
Oncotarget, 2019, 10 (7), pp.696-706
ISSN
1949-2553
Publisher
Impact Journals
Start Page
696
End Page
706
Journal / Book Title
Oncotarget
Volume
10
Issue
7
Copyright Statement
© 2019 Gall et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0 - https://creativecommons.org/licenses/by/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor
The Alliance Family Foundation
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30774772
PII: 26511
Grant Number
N/A
Subjects
PDAC
cell-free DNA
ion torrent
nanostring
next-generation sequencing
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2019-01-22