Faculty Collaboration Database

Molecular metastases in stage I pancreatic cancer: improved survival with adjuvant chemoradiation. Surgery 1998 Oct;124(4):663-9

Date

10/22/1998

Pubmed ID

9780986

DOI

10.1067/msy.1998.91487

Scopus ID

2-s2.0-0031715016 (requires institutional sign-in at Scopus site)   49 Citations

Abstract

BACKGROUND: Reports of improved survival rates for patients with resected adenocarcinoma of the pancreas coincide with the adoption of adjuvant chemoradiation protocols. The impact of nodal micrometastases demonstrated by molecular assays and adjuvant therapy on survival of patients with stage I pancreatic cancer has not been adequately assessed.

METHODS: A retrospective analysis of postoperative chemoradiation on survival in 61 patients undergoing resection of pancreatic adenocarcinomas from 1984 to 1997 was performed. Archival tumors and regional nodes from 25 patients with stage I cancers were tested for a Kiras oncogene mutation using polymerase chain reaction and analysis for restriction fragment length polymorphisms (PCR/RFLP).

RESULTS: Adjuvant chemoradiation was associated with improved survival for stage I (P < .01), but not stage III, disease. Seventeen (68%) of 25 patients with stage I disease tested had evidence of mutant Kiras in one or more regional nodes. Survival did not differ for patients with molecular micrometastases. Six of 17 (35%) patients with micrometastases received adjuvant chemoradiation and had improved survival (P < .05).

CONCLUSIONS: The majority of patients with stage I pancreatic cancer have PCR/RFLP evidence of lymph node micrometastases. Adjuvant chemoradiation improves survival in these patients by treating micrometastases not detected by histology. Adjuvant chemoradiation should be used for patients with stage I pancreatic cancers.

Author List

Demeure MJ, Doffek KM, Komorowski RA, Redlich PN, Zhu YR, Erickson BA, Ritch PS, Pitt HA, Wilson SD

Authors

Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Philip N. Redlich MD, PhD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Aged
Chemotherapy, Adjuvant
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Pancreatic Neoplasms
Point Mutation
Polymerase Chain Reaction
Polymorphism, Restriction Fragment Length
Proto-Oncogene Proteins p21(ras)
Radiotherapy, Adjuvant
Retrospective Studies
Survival Rate