Members Members Residents Job Board
Join Today Renew Your Membership Make A Donation
2006 Abstracts: Do p16, p53, or MUC4 Mutations Affect Outcomes after Pancreaticoduodenectomy for Pancreatic Adenocarcinoma?
Back to 2006 Program and Abstracts
Do p16, p53, or MUC4 Mutations Affect Outcomes after Pancreaticoduodenectomy for Pancreatic Adenocarcinoma?
John D. Christein1, Ruth R. Leeth1, Rashmi K. Murthy1, Martin Heslin1, Nirag C. Jhala2, Juan P. Arnoletti1, Selwyn M. Vickers1; 1Surgery, University of Alabama at Birmingham, Birmingham, AL; 2Pathology, University of Alabama at Birmingham, Birmingham, AL

Background: The implications of biological markers as they relate to outcomes after pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma is unclear in the literature. Purpose: To determine associations between MUC4, p16, and p53 mutations with outcomes in patients after PD for pancreatic adenocarcinoma. Methods: All patients undergoing R0 or R1 PD for pancreatic adenocarcinoma from 1997 - 2005 were included in this review. All pathology reports were updated according to the AJCC 6th edition. Specimens were immunohistochemically stained using antibodies for MUC4, p53, and p16. Appropriate positive and negative controls were stained to determine validity. For both p53 and p16, tumor specimens with a percentage of positive cells greater than the mean plus 2 standard deviations were considered positive. Tumor specimens stained for MUC4 were categorized into a low expression group (<20% positive cells) or a high expression group (20% positive cells). Student’s t-tests and Chi-square were used to describe differences between expression groups. The Kaplan-Meier method was used to determine survival; univariate and multivariate analyses using the Cox proportional hazards regression model were performed to ascertain impact on survival. Results: 126 patients underwent PD for adenocarcinoma with follow-up available on all but 5 patients (96%). Sixty-seven percent were male and the mean age was 65 years. 9.5% of patients were under 50 years of age. Mean tumor size was 3 cm. Fifteen patients underwent R1 resections (12%). Median survival was 22 months. 108 cases (86%) had tissue available for staining. High MUC4 expression was present in 91 cases (84%). Survival between low and high MUC4 expression groups was significantly different, 12 vs. 18 months, respectively (p<0.03). There was an inverse relationship between p53 and p16 positivity. Patients with a p16 mutation were more likely to be African-American (p=0.02), undergo an R1 resection (p<0.01), and have smaller tumors (p<0.05). Overall, p53 and p16 results did not affect survival. Of the variables analyzed, surgical margin was the only independent predictor of survival, with a 2.5 times greater rate of death for patients with positive margins (p<0.01). Conclusion: Survival for pancreatic adenocarcinoma patients after PD with MUC4 expression <20% positive cells was significantly worse than that for patients with high MUC4 expression. African-Americans were more likely to be p16 positive. Multivariate analysis determined surgical margin to be predictive of survival after PD for pancreatic adenocarcinoma.


Back to 2006 Program and Abstracts


Society for Surgery of the Alimentary Tract

Facebook Twitter YouTube

Email SSAT Email SSAT
500 Cummings Center, Suite 4400, Beverly, MA 01915 500 Cummings Center
Suite 4400
Beverly, MA 01915
+1 978-927-8330 +1 978-927-8330
+1 978-524-0498 +1 978-524-0498
Links
About
Membership
Publications
Newsletters
Annual Meeting
Join SSAT
Job Board
Make a Pledge
Event Calendar
Awards