Precision Oncology in Surgery: Patient Selection for Operable Pancreatic Cancer.

Autor:	Dreyer SB; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom.; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom., Pinese M; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Jamieson NB; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom.; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.; Academic Unit of Surgery, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom., Scarlett CJ; School of Environmental and Life Sciences, University of Newcastle, Ourimbah, NSW, Australia., Colvin EK; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Pajic M; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Johns AL; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Humphris JL; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Wu J; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Cowley MJ; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Chou A; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia.; Department of Anatomical Pathology, St. Vincent's Hospital, Sydney, NSW, Australia., Nagrial AM; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Chantrill L; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Chin VT; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia., Jones MD; Stratified Medicine Scotland, Queen Elizabeth University Hospital, Glasgow, United Kingdom., Moran-Jones K; College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom., Carter CR; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom., Dickson EJ; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom., Samra JS; Department of Surgery, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.; University of Sydney, Sydney, NSW, Australia., Merrett ND; School of Medicine, Western Sydney University, Penrith, NSW, Australia.; Department of Surgery, Bankstown Hospital, Sydney, NSW, Australia., Gill AJ; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia.; Cancer Diagnosis and Pathology Group Kolling Institute of Medical Research and Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia.; Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia., Kench JG; The Kinghorn Cancer Centre, Darlinghurst and Garvan Institute of Medical Research, Sydney, Australia.; Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia., Duthie F; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom.; Department of Pathology, Queen Elizabeth University Hospital, Glasgow, United Kingdom., Miller DK; Illumina Inc, San Diego, CA., Cooke S; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom., Aust D; Institute for Pathology, TU Dresden, Dresden, Germany., Knösel T; Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany., Rümmele P; Department of Pathology, Universitätsklinikum Erlangen, Erlangen, Germany., Grützmann R; Department of Surgery, Universitätsklinikum Erlangen, Erlangen, Germany., Pilarsky C; Department of Surgery, Universitätsklinikum Erlangen, Erlangen, Germany., Nguyen NQ; Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, Australia., Musgrove EA; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom., Bailey PJ; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom., McKay CJ; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom.; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom., Biankin AV; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom.; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom., Chang DK; Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom.; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2020 Aug; Vol. 272 (2), pp. 366-376.
DOI:	10.1097/SLA.0000000000003143
Abstrakt:	Objective: We aimed to define preoperative clinical and molecular characteristics that would allow better patient selection for operative resection. Background: Although we use molecular selection methods for systemic targeted therapies, these principles are not applied to surgical oncology. Improving patient selection is of vital importance for the operative treatment of pancreatic cancer (pancreatic ductal adenocarcinoma). Although surgery is the only chance of long-term survival, 80% still succumb to the disease and approximately 30% die within 1 year, often sooner than those that have unresected local disease. Method: In 3 independent pancreatic ductal adenocarcinoma cohorts (total participants = 1184) the relationship between aberrant expression of prometastatic proteins S100A2 and S100A4 and survival was assessed. A preoperative nomogram based on clinical variables available before surgery and expression of these proteins was constructed and compared to traditional measures, and a postoperative nomogram. Results: High expression of either S100A2 or S100A4 was independent poor prognostic factors in a training cohort of 518 participants. These results were validated in 2 independent patient cohorts (Glasgow, n = 198; Germany, n = 468). Aberrant biomarker expression stratified the cohorts into 3 distinct prognostic groups. A preoperative nomogram incorporating S100A2 and S100A4 expression predicted survival and nomograms derived using postoperative clinicopathological variables. Conclusions: Of those patients with a poor preoperative nomogram score, approximately 50% of patients died within a year of resection. Nomograms have the potential to improve selection for surgery and neoadjuvant therapy, avoiding surgery in aggressive disease, and justifying more extensive resections in biologically favorable disease.
Databáze:	MEDLINE
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