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Open AccessArticle
The Association between Sampling and Survival in Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant Therapy and Pancreaticoduodenectomy
by
Mehran Taherian
Mehran Taherian
Matthew H. G. Katz
Matthew H. G. Katz
Matthew H.G. Katz is a professor and chair of the Department of Surgical Oncology, and he holds the [...]
Matthew H.G. Katz is a professor and chair of the Department of Surgical Oncology, and he holds the Lockton distinguished chair position in pancreatic cancer research. An international leader in the treatment of pancreatic and periampullary malignancies, he has led two national cooperative group studies on the effects of chemotherapy and radiation on patients with advanced pancreatic cancer, has run several single-institution and multi-institution clinical trials, and has served as a senior author of national clinical guidelines for the treatment of potentially curable pancreatic cancer. He has served in national leadership roles within major surgical and cancer-related societies, including the American Society of Clinical Oncology (ASCO) and the American College of Surgeons (ACS). In the ACS, he leads efforts to improve the quality of care provided to people with cancer worldwide through the development and implementation of technical surgical standards.
Laura R. Prakash
Laura R. Prakash 
,
Dongguang Wei
Dongguang Wei
Yi Tat Tong
Yi Tat Tong
Zongshan Lai
Zongshan Lai
Deyali Chatterjee
Deyali Chatterjee
Deyali Chatterjee is an associate professor of pathology at MD Anderson with clinical and research a [...]
Deyali Chatterjee is an associate professor of pathology at MD Anderson with clinical and research experience in the field of gastrointestinal, pancreatic, and hepatobiliary pathology. She is the associate director of the Surgical Pathology Fellowship Program and is deeply involved in trainee education. She is actively involved with various national and international professional organizations. She serves on the education committee of the Pancreatobiliary Pathology Society, on the NCCN Panel for Neuroendocrine Tumors, as an expert panel member for the College of American Pathologists (CAP) evidence-based guidelines on the evaluation of gastroenteropancreatic neuroendocrine tumors, and as a consultant for the Neuroendocrine Disease Focused Panel (DFP) of the Society of Abdominal Radiology (SAR). She has previously been involved as an expert panel member for an international committee on periampullary neoplasms (PERIPAN).
Hua Wang
Hua Wang
Michael Kim
Michael Kim
Ching-Wei D. Tzeng
Ching-Wei D. Tzeng
Ching-Wei D. Tzeng is an associate professor of surgical oncology at the MD Anderson Cancer Center, [...]
Ching-Wei D. Tzeng is an associate professor of surgical oncology at the MD Anderson Cancer Center, specializing in the treatment of hepato-pancreato-biliary (HPB) cancers. He serves in the roles of the department vice chair of clinical operations, the program director for the HPB Surgery Fellowship, and a member of the Program Education Committee of the Surgical Oncology Fellowship. His surgical society roles include chairing the SSAT Program Committee and serving on the AHPBA Education and Training Committee, the AHPBA Program Directors Committee, and the Fellowship Council Membership Committee. His clinical research focuses on perioperative quality improvement, cancer surgery standards, quality of life measures, and patient-centered opioid reduction protocols, for which he was named a 2021 Andrew Sabin Family Foundation Fellow. He is also an educator dedicated to the training of fellows, residents, and students, and he has been recognized with multiple teaching awards, including the 2021 University of Texas Regents’ Outstanding Teaching Award and the 2022 Department of Surgical Oncology Outstanding Teaching Award for Research.
Naruhiko Ikoma
Naruhiko Ikoma
Naruhiko Ikoma, MD, is a surgical oncologist specializing in minimally invasive surgery (robotic and [...]
Naruhiko Ikoma, MD, is a surgical oncologist specializing in minimally invasive surgery (robotic surgery) and multidisciplinary therapy on pancreas cancer, bile duct cancer, and gastric cancer. He completed fellowships in surgical oncology at MD Anderson Cancer Center and Keio University School of Medicine (Tokyo, Japan) and is board-certified both in the United States and Japan. He received his master’s degree in public health from the University of Texas School of Public Health. His clinical research interests include improving short- and long-term treatment outcomes using minimally invasive (robotic) surgery techniques for pancreas and gastric cancers. He has received multiple research awards from the Society of Surgical Oncology and the Japanese Surgical Society for his gastric cancer research. He is also interested in improving racial disparity to deliver high-quality cancer treatment equally to all patients through his public health research. He is an active collaborator in translational research projects concerning localized treatment for pancreatic and bile duct tumors.
Robert A. Wolff
Robert A. Wolff
Dan Zhao
Dan Zhao
Eugene J. Koay
Eugene J. Koay
Anirban Maitra
Anirban Maitra
Anirban Maitra is a professor of pathology and translational molecular pathology and the scientific [...]
Anirban Maitra is a professor of pathology and translational molecular pathology and the scientific director of the Sheikh Ahmed Pancreatic Cancer Research Center at the UT MD Anderson Cancer Center, Houston (since August 2013). He is the principal investigator of an NCI-funded laboratory dedicated to pancreatic cancer research. He has trained over three dozen postdoctoral fellows and graduate students, many of whom are now in independent faculty positions in the United States or worldwide. The arc of his research career has been defined by contributions made in the spheres of genetics and the molecular pathology of pancreatic cancer and its precursor lesions in both human and cognate mouse models of pancreatic neoplasia. He is deeply committed to identifying and implementing translational research opportunities in pancreatic cancer that can improve the survival of patients stricken with this disease, with a particular focus on early detection and cancer interception. He has been a leader in numerous programmatic efforts in pancreatic cancer, funded through both the NCI and foundations such as Stand-Up-To-Cancer/AACR.
Huamin Wang
Huamin Wang
Huamin Wang is a professor of pathology specializing in gastrointestinal pathology, a and the chief [...]
Huamin Wang is a professor of pathology specializing in gastrointestinal pathology, a physician-scientist, and the chief of gastrointestinal pathology. He received his MD from Tongji Medical University in Wuhan, China, and his PhD in Biochemistry and Molecular Biology from the University of Texas. He then completed a residency program and fellowship at the University of Texas. He joined the MD Anderson Cancer Center in 2004. He has a strong passion for innovative translational research, mainly focused on pancreatic cancer, and he has served as principal investigator (PI), pathology core leader/Core PIs, or co-PI for more than 40 research grants, including SPOREs, P01s, U01s, many other NIH/NCI grants, and grants from various foundations. His laboratory research, funded by two NIH/NCI R01 grants, has been focused on many aspects of pancreatic cancer, including protein kinase and phosphatase alterations, novel pathophysiologic mechanisms, and the development of new biomarkers. He has also been actively involved in the clinicopathologic studies on histopathologic predictors and molecular biomarkers in pancreatic cancer patients who received neoadjuvant therapies and in treatment-naïve pancreatic cancer patients. He has been the co-director of the pancreatic cancer tumor bank at MDACC since 2004 and has enjoyed productive collaborations with many elite scientists and clinicians on pancreatic cancer research both inside MDACC and across the United States.
1
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
2
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
3
Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
4
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
Submission received: 31 July 2024
/
Revised: 12 September 2024
/
Accepted: 25 September 2024
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Published: 27 September 2024
Simple Summary
We examined the association of the entire submission of the tumor (ESOT) and the entire submission of the pancreas (ESOP) with clinicopathologic features and survival in 627 pancreatic cancer patients who received neoadjuvant therapy (NAT). We demonstrated that both ESOT and ESOP were associated with lower ypT, less frequent perineural invasion, and better tumor response. Both ESOT and ESOP were associated with less frequent recurrence/metastasis, better disease-free survival (DFS), and overall survival (OS) in the overall study population. ESOP was associated with better DFS and OS in patients with ypT0/ypT1 or ypN0 tumors and better OS in patients with complete or near-complete response. ESOT was associated with better OS in patients with ypT0/ypT1 or ypN0 tumors. Both ESOT and ESOP were independent prognostic factors for OS in multivariate survival analyses. Therefore, ESOP and ESOT are associated with the prognosis of PDAC patients with complete or near-complete response and a ypT0/ypT1 tumor after NAT.
Abstract
Adequate sampling is essential to an accurate pathologic evaluation of pancreatectomy specimens resected for pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy (NAT). However, limited data are available for the association between the sampling and survival in these patients. We examined the association of the entire submission of the tumor (ESOT) and the entire submission of the pancreas (ESOP) with disease-free survival (DFS) and overall survival (OS), as well as their correlations with clinicopathologic features, for 627 patients with PDAC who received NAT and pancreaticoduodenectomy. We demonstrated that both ESOT and ESOP were associated with lower ypT, less frequent perineural invasion, and better tumor response (p < 0.05). ESOP was also associated with a smaller tumor size (p < 0.001), more lymph nodes (p < 0.001), a lower ypN stage (p < 0.001), better differentiation (p = 0.02), and less frequent lymphovascular invasion (p = 0.009). However, since ESOP and ESOT were primarily conducted for cases with no grossly identifiable tumor or minimal residual carcinoma in initial sections, potential bias cannot be excluded. Both ESOT and ESOP were associated with less frequent recurrence/metastasis and better DFS and OS (p < 0.05) in the overall study population. ESOP was associated with better DFS and better OS in patients with ypT0/ypT1 or ypN0 tumors and better OS in patients with complete or near-complete response (p < 0.05). ESOT was associated with better OS in patients with ypT0/ypT1 or ypN0 tumors (p < 0.05). Both ESOT and ESOP were independent prognostic factors for OS according to multivariate survival analyses. Therefore, accurate pathologic evaluation using ESOP and ESOT is associated with the prognosis in PDAC patients with complete or near-complete pathologic response and ypT0/ypT1 tumor after NAT.
Share and Cite
MDPI and ACS Style
Taherian, M.; Katz, M.H.G.; Prakash, L.R.; Wei, D.; Tong, Y.T.; Lai, Z.; Chatterjee, D.; Wang, H.; Kim, M.; Tzeng, C.-W.D.;
et al. The Association between Sampling and Survival in Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant Therapy and Pancreaticoduodenectomy. Cancers 2024, 16, 3312.
https://doi.org/10.3390/cancers16193312
AMA Style
Taherian M, Katz MHG, Prakash LR, Wei D, Tong YT, Lai Z, Chatterjee D, Wang H, Kim M, Tzeng C-WD,
et al. The Association between Sampling and Survival in Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant Therapy and Pancreaticoduodenectomy. Cancers. 2024; 16(19):3312.
https://doi.org/10.3390/cancers16193312
Chicago/Turabian Style
Taherian, Mehran, Matthew H. G. Katz, Laura R. Prakash, Dongguang Wei, Yi Tat Tong, Zongshan Lai, Deyali Chatterjee, Hua Wang, Michael Kim, Ching-Wei D. Tzeng,
and et al. 2024. "The Association between Sampling and Survival in Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant Therapy and Pancreaticoduodenectomy" Cancers 16, no. 19: 3312.
https://doi.org/10.3390/cancers16193312
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