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Ploidy and survival in resectable pancreatic cancers. A retrospective study over 9 years
E Schlichting1, O P Clausen, A S Hanssen
1Department of Surgery, Ullevaal Hospital, Oslo, Norway.
Objective:
To evaluate the association between ploidy and operability and prognosis in pancreatic cancer.
Design:
Retrospective study.
Setting:
Ullevaal Hospital and the National Hospital of Norway, Oslo.
Subjects:
148 patients with histologically verified pancreatic cancer diagnosed between 1980 and 1988.
Interventions:
29 patients had radical resections (18 Whipple procedures and 11 total pancreatectomies). Archival tissue was investigated in the blocks from these tumours, and from five patients who had only a biopsy taken, by DNA flow cytometry.
Results:
26/29 tumours excised radically had diploid DNA stemlines. Two of the three aneuploid stemlines were hyperdiploid, and the third was almost triploid. Among the five inoperable tumours, two were aneuploid and three diploid. The patients who underwent radical operations lived a median of 11.5 months (range 0-82), compared with a median of 4 months (range 0-58) for those whose tumours were inoperable. Six of the 29 patients were still alive without signs of recurrent disease 51.5 months (range 41-82) after operation. All but one of these tumours had diploid DNA stemlines, and synthesis (S) phase fractions below the median value for the whole group.
Conclusion:
DNA ploidy and S phase fraction are prognostic factors in pancreatic cancer.