| Autor: |
Amaral MJ; General Surgey Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal.; Faculty of Medicine, Universiy of Coimbra, 3000-548 Coimbra, Portugal., Amaral M; Faculty of Medicine, Universiy of Coimbra, 3000-548 Coimbra, Portugal., Freitas J; Faculty of Medicine, Universiy of Coimbra, 3000-548 Coimbra, Portugal., Oliveira RC; Pathology Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal.; Clinical Academic Center of Coimbra (CACC), 3000-075 Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal., Serôdio M; General Surgey Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal.; Faculty of Medicine, Universiy of Coimbra, 3000-548 Coimbra, Portugal., Cipriano MA; Pathology Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal., Tralhão JG; General Surgey Department, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal.; Faculty of Medicine, Universiy of Coimbra, 3000-548 Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.; Biophysics Institute, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal. |
| Abstrakt: |
Pancreatic ductal adenocarcinoma (PDAC) has a dense stroma, responsible for up to 80% of its volume. The amount of stroma can be associated with prognosis, although there are discrepancies regarding its concrete impact. The aim of this work was to study prognostic factors for PDAC patients submitted to surgery, including the prognostic impact of the tumor stroma area (TSA). A retrospective study with PDAC patients submitted for surgical resection was conducted. The TSA was calculated using QuPath-0.2.3 software. Arterial hypertension, diabetes mellitus, and surgical complications Clavien-Dindo>IIIa are independent risk factors for mortality in PDAC patients submitted to surgery. Regarding TSA, using >1.9 × 10 11 µ 2 as cut-off value for all stages, patients seem to have longer overall survival (OS) (31 vs. 21 months, p = 0.495). For stage II, a TSA > 2 × 10 11 µ 2 was significantly associated with an R0 resection ( p = 0.037). For stage III patients, a TSA > 1.9 × 10 11 µ 2 was significantly associated with a lower histological grade ( p = 0.031), and a TSA > 2E + 11 µ 2 was significantly associated with a preoperative AP ≥ 120 U/L ( p = 0.009) and a lower preoperative AST (≤35 U/L) ( p = 0.004). Patients with PDAC undergoing surgical resection with preoperative CA19.9 > 500 U/L and AST ≥ 100 U/L have an independent higher risk of recurrence. Tumor stroma could have a protective effect in these patients. A larger TSA is associated with an R0 resection in stage II patients and a lower histological grade in stage III patients, which may contribute to a longer OS. |
