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DNA ploidy and S + G2M fraction (proliferative index) as prognostic determinants in human periampullary cancer
R Jorba1, E Jaurrieta, R Bernat
1Department of General Surgery, Hospital Princeps d'Espanya, L'Hospitalet de Llobregat, Barcelona, Spain.
Background/Aims:
The aim of the present study was to investigate the relationship between pathological factors, DNA ploidy patterns, proliferative index and survival in a population of patients undergoing resection for adenocarcinoma of periampullary region.
Materials And Methods:
DNA ploidy and proliferative index of periampullary cancer tissue was measured by flow cytometry in 73 patients who had undergone pancreatoduodenectomy.
Results:
Seventy-four percent (n = 54) of cancers were diploid and 26% (n = 19) were aneuploid. The median survival time of patients with diploid cancers was 30.1 (s.d. 5.1) months and with aneuploid cancers was 16.0 (s.d. 2.9) months (p = 0.02). Kaplan-Meier survival curves showed that the patients with aneuploid cancers succumbed to recurrent disease within 40 months after surgery whereas 20% of patients with diploid cancers survived longer than 40 months. In patients with long survival (3 years) there was a significant difference between aneuploid and diploid cancers (p < 0.001). In the multivariate analysis, tumor location and tumor size are independent prognostic variables for the length of survival after resection of periampullary cancer.
Conclusions:
DNA ploidy pattern appears to be one important prognostic predictor in patients with "long term" survival after successful pancreatoduodenectomy for periampullary cancers.