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Clinical Implications of Pre- and Postoperative Circulating Tumor DNA in Patients with Resected Pancreatic Ductal Adenocarcinoma

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The clinical implications of pre- and postoperative KRAS-mutated circulating tumor DNA (ctDNA) present in patients with pancreatic ductal adenocarcinoma (PDAC) have remained an unresolved issue. This study sought to investigate the clinical significance of pre- and postoperative ctDNA analyses and their impact on the prognosis of PDAC patients.

Methods

Digital droplet polymerase chain reaction detected ctDNA in pre- and postoperative plasma samples prospectively obtained from patients with resectable and borderline-resectable PDAC. Its associations with recurrence-free survival (RFS) and overall survival (OS) were analyzed. The patients were sorted according to the presence of pre- and postoperative ctDNA, and its ability to stratify prognosis was evaluated.

Results

The study analyzed 97 patients. Both pre- and postoperative ctDNA were detected in 9 patients, and neither was detected in 55 patients. Whereas 15 patients harbored only preoperative ctDNA, 18 patients had only postoperative ctDNA. The multivariate analysis showed that the presence of preoperative ctDNA was associated with poorer OS (P = 0.008) and that postoperative ctDNA was not associated with either RFS or OS. Survival did not differ significantly between the patients with a positive shift in ctDNA status and those without detectable pre- or postoperative ctDNA.

Conclusions

For the patients with PDAC, the presence of preoperative ctDNA was significantly associated poor OS, whereas postoperative ctDNA was not associated with poor survival. A positive change in ctDNA did not affect patients’ survival.

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Acknowledgment

This study was supported by the Tsuchiya Foundation. A part of this study was performed at the Analysis Center of Life Science, the Natural Science Center for Basic Research and Development, and Hiroshima University. The authors are very grateful to Shoko Hirano for technical assistance with the experiment.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Takuro Yamaguchi MD, Kenichiro Uemura MD, Yoshiaki Murakami MD, Naru Kondo MD, Naoya Nakagawa MD, Kenjiro Okada MD, Shingo Seo MD, Shinya Takahashi MD & Taijiro Sueda MD

  2. Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan

    Eiso Hiyama MD

  3. Department of Surgery, Hiroshima City Aki Hospital, Hiroshima, Japan

    Taijiro Sueda MD

Authors
  1. Takuro Yamaguchi MD
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  2. Kenichiro Uemura MD
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  3. Yoshiaki Murakami MD
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  4. Naru Kondo MD
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  5. Naoya Nakagawa MD
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  6. Kenjiro Okada MD
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  7. Shingo Seo MD
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  8. Eiso Hiyama MD
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  9. Shinya Takahashi MD
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  10. Taijiro Sueda MD
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Correspondence to Kenichiro Uemura MD.

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Yamaguchi, T., Uemura, K., Murakami, Y. et al. Clinical Implications of Pre- and Postoperative Circulating Tumor DNA in Patients with Resected Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 28, 3135–3144 (2021). https://doi.org/10.1245/s10434-020-09278-9

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  • DOI: https://doi.org/10.1245/s10434-020-09278-9

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