Clinical and Translational Oncology

, Volume 21, Issue 7, pp 954–959 | Cite as

Still a place for conventional histopathological analysis in the era of molecular medicine: predicting prognosis of resectable ductal pancreatic adenocarcinoma

  • M. J. Fernández AceñeroEmail author
  • J. Martínez-Useros
  • L. Díez-Valladares
  • S. García-Botella
  • L. Ortega Medina
  • E. Pérez Aguirre
  • S. de la Serna Esteban
  • E. Latorre
  • L. Neelsen
Brief Research Article



Our aim is to find features that define prognosis in surgically resected ductal pancreatic adenocarcinoma readily accessible in everyday practice.

Materials and methods

Longitudinal retrospective case series of pancreatic adenocarcinoma operated with a curative intent in a large tertiary hospital in Madrid between 2009 and 2015.


162 were enrolled. 40.8% survived less than 1 year. Multivariate Cox’s regression model revealed that gender, presence of symptoms, T and N stage independently influenced progression-free survival, while overall survival was determined by gender, smoking, presence of symptoms and N stage. Logistic regression analysis revealed that only symptoms at diagnosis could predict death, while gender, symptoms, histopathological type, vessel invasion, T stage and necrosis could independently predict recurrence.


Our series show that patients with symptomatic disease at the time of diagnosis and females showed a shorter progression-free and overall survival. We herein propose a regression model to predict outcome.


Pancreas Adenocarcinoma Surgical therapy Prognosis 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest for the present study.

Ethical approval

The project has been reviewed and approved by the Ethical Committee for Research at Hospital Clínico San Carlos.

Informed consent

As no personal data are shown, the authors have asked the committee for a informed consent waiver in dead patients, which has been given to us.


  1. 1.
    Siegel R, Naishadam D, Jemal A. Cancer statistics 2013. CA Cancer J Clin. 2013;63:11–30.CrossRefGoogle Scholar
  2. 2.
    Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 2018;103:356–87.CrossRefGoogle Scholar
  3. 3.
    Golan T, Sella T, Margalit O, Amit U, Halpern N, Aderka D, et al. Short- and long-term survival in metastatic pancreatic adenocarcinoma, 1993–2013. J Natl Compr Cancer Netw. 2017;15:1022–7.CrossRefGoogle Scholar
  4. 4.
    Mirkin KA, Greenleaf EK, Hollenbeak CS, Wong J. Correlation of clinical and pathological staging and response to neoadjuvant therapy in resected pancreatic cancer. Int J Surg. 2018;52:221–8.CrossRefGoogle Scholar
  5. 5.
    Bijlsma MF, Sadanandam A, Tan P, Vermeulen L. Molecular subtypes in cancers of the gastrointestinal tract. Nat Rev Gastroenterol Hepatol. 2017;14:333–42.CrossRefGoogle Scholar
  6. 6.
    Birnbaum DJ, Finetti P, Lopresti A, Gilabert M, Poizat F, Raouls JL, et al. A 25-gene classifier predicts overall survival in resectable pancreatic cancer. BMC Med. 2017;15:170. Scholar
  7. 7.
    Pozios I, Knösel T, Zhao Y, Assmann G, Pozios I, Müller MH, et al. Expression of phosphorylated estrogen receptor beta is an independent negative prognostic factor for pancreatic ductal adenocarcinoma. J Cancer Res Clin Oncol. 2018;144:1887–97.CrossRefGoogle Scholar
  8. 8.
    Silvestris N, Gnoni A, Brunetti AE, Vincenti L, Santini D, Tonini G, et al. Target therapies in pancreatic carcinoma. Curr Med Chem. 2014;21:948–65.CrossRefGoogle Scholar
  9. 9.
    Chang JC, Kundranda M. Novel diagnostic and predictive biomarkers in pancreaticadenocarcinoma. Int J Mol Sci. 2017;18:E667. Scholar
  10. 10.
    Westgaard A, Clausen OP, Gladhaug IP. Survival estimates after pancreatoduodenectomy skewed by non-standardized histopathology reports. APMIS. 2011;119:689–700.CrossRefGoogle Scholar
  11. 11.
    Tang B, Lv J, Li Y, Yuan S, Wang Z, He S. Relationship between female hormonal and menstrual factors and pancreatic cancer: a meta-analysis of observational studies. Medicine (Baltim). 2015;94:e177. Scholar
  12. 12.
    Kanno A, Masamune A, Hanada K, Maguchi H, Shimizu Y, Ueki T, et al. Multicenter study of early pancreatic cancer in Japan. Pancreatology. 2018;18:61–7.CrossRefGoogle Scholar
  13. 13.
    Macías N, Sayagués JM, Esteban C, Iglesias M, González LM, Quiñones-Sampedro J, et al. Histologic tumor grade and preoperative biliary drainage are the unique independent prognostic factors of survival in pancreatic ductal adenocarcinoma patients after pancreaticoduodenectomy. J Clin Gastroenterol. 2018;52:e11–7.Google Scholar
  14. 14.
    van der Gaag NA, Rauws EA, van Eijck CH, Bruno MJ, van der Harst E, Kubben FJ, et al. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med. 2010;362:129–37.CrossRefGoogle Scholar
  15. 15.
    Yuan C, Morales-Oyarvide V, Babic A, Clish CB, Kraft P, Bao Y, et al. Cigarette smoking and pancreatic cancer survival. J Clin Oncol. 2017;35:1822–8.CrossRefGoogle Scholar
  16. 16.
    Luchini C, Capelli P, Scarpa A. Pancreatic ductal adenocarcinoma and its variants. Surg Pathol Clin. 2016;9:547–60.CrossRefGoogle Scholar
  17. 17.
    Morini S, Perrone G, Borzomati D. Carcinoma of the ampulla of Vater: morphological and immunophenotypical classification predicts overall survival. Pancreas. 2013;42:60–6.CrossRefGoogle Scholar
  18. 18.
    Makita K, Kamigaki T, Okada S, Matsuda E, Ibe H, Oguma E, et al. Prognostic factors for pancreatic cancer patients treated with immune-cell therapy. Anticancer Res. 2018;38:4353–60.CrossRefGoogle Scholar
  19. 19.
    Zhu Y, Knolhoff BL, Meyer MA, Nywening TM, West BL, Luo J, et al. CSF1/CSF1R blockade reprograms tumor-infiltrating macrophages and improves response to T cell checkpoint immunotherapy in pancreatic cancer models. Cancer Res. 2014;74:5057–69.CrossRefGoogle Scholar
  20. 20.
    Li Q, Gao C, Li H, Juzi JT, Chen H. Hao X factors associated with survival after surgical resection in Chinese patients with ductal adenocarcinoma of the pancreatic head. Dig Surg. 2008;25:87–92.CrossRefGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  • M. J. Fernández Aceñero
    • 1
    Email author
  • J. Martínez-Useros
    • 2
  • L. Díez-Valladares
    • 3
  • S. García-Botella
    • 3
  • L. Ortega Medina
    • 1
  • E. Pérez Aguirre
    • 3
  • S. de la Serna Esteban
    • 3
  • E. Latorre
    • 1
  • L. Neelsen
    • 1
  1. 1.Department of Surgical PathologyHospital Clínico San CarlosMadridSpain
  2. 2.Department of Traslational OncologyFundación Jiménez Díaz, Universidad Autónoma de MadridMadridSpain
  3. 3.Surgery (Pancreatobiliary Unit)Hospital Clínico San CarlosMadridSpain

Personalised recommendations