Prognostic significance of DNA cytometry for adjuvant therapy response in pancreatic cancer

Background and ObjectivesThe continuous progress in treatment options for pancreatic adenocarcinoma has lead to a re-evaluation of prognostic markers. In this study the prognostic relevance of DNA Index and classical histopathological parameters with regard to disease-free (DFS) and overall survival (OS) was analyzed within the CONKO-001 patient population. MethodsOne hundred forty three fresh-frozen paraffin-embedded tissue samples of the resected tumor specimen of the CONKO-001 patient population were available for DNA index analysis to evaluate its impact on patient outcome. ResultsMedian DFS (7.3 vs. 14.3months; P=0.004) and median OS (16.6 vs. 29.2months; P=0.011) were significantly decreased in patients with a high DNA index (>1.4). Multivariate analysis revealed both DNA index (DFS: P=0.002; OS: P=0.019) and tumor grading (DFS: P=0.004; OS: P=0.004) as individual prognostic markers for DFS and OS. The following prognostic subgroups were identified: good (low DNA Index+G1/2 tumor grading), intermediate (low DNA Index+G3 tumor grading or high DNA Index+G1/2 tumor grading), poor (high DNA Index+G3 tumor grading). ConclusionThe DNA index/tumor grading constellation may serve as a helpful guide for personalized treatment recommendations for adjuvant therapy of patients with pancreatic adenocarcinoma. J. Surg. Oncol. 2015 111:66-71. (c) 2015 Wiley Periodicals, Inc.