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Histological prognostic parameters for adenocarcinoma of the pancreatic head. Proposal for a scoring system for prediction of outcome

  • Original Articles
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

To find new histopathological prognostic parameters for adenocarcinoma of the pancreatic head, 27 of these carcinomas, at stage IV according to the Japan Pancreas Society, which had been curatively resected, were histologically examined. In addition to previously recognized histological prognostic parameters, sections were examined for the following factors: fibrotic focus (FF), direct invasion of the tumor into the lymph node (DILN), and tumor necrosis (TN). Frequency of tumor recurrence or death was higher in patients with any one of the three new factors than in those without any of these factors. To develop an accurate system for predicting the outcome, the presence or absence of each factor and lymphatic permeation was given a score of 1 (present) or 0 (absent), and the total score was than calculated for each patient. All patients with a score of 0 were alive without tumor recurrence, at a mean follow-up of 20 months, whereas all seven patients with a score of 4 had experienced tumor recurrence, and six died subsequently. The results of this study demonstrated that FF, DILN, and TN are good histological parameters of ductal adenocarcinoma of the pancreatic head, and that the scoring system proposed in this paper is useful for prediction of the outcome of the disease.

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References

  1. Yamamoto M, Saito Y (1994) Tumor spread and the factors influencing prognosis in patients with resected pancreatic carcinoma. In: Pour PM, Konishi Y, Klöppel G, Longnecker DS (eds) Atlas of exocrine pancreatic tumors. Morphology, biology, and diagnosis with an international guide for tumor classification. Springer, Berlin Heidelberg New York Tokyo, pp 237–246

    Google Scholar 

  2. Geer RJ, Brennan MF (1993) Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg 165:68–73

    Article  PubMed  CAS  Google Scholar 

  3. Tsuchiya R, Oribe T, Noda T (1985) Size of the tumor and other factors influencing prognosis of carcinoma of the head of the pancreas. Am J Gastroenterology 80:459–463

    CAS  Google Scholar 

  4. Cameron JL, Crist DW, Sitzmann JV, Hruban RH, Boitnott JK, Seidler AJ, Coleman JA (1991) Factors influencing survival after pancreaticoduodenectomy for pancreatic cancer. Am J Surg 161:120–125

    Article  PubMed  CAS  Google Scholar 

  5. Tannapfel A, Wittekind C, Hunefeld G (1992) Ductal adenocarcinoma of the pancreas. Histopathological features and prognosis. Int J Pancreatol 12:145–152

    PubMed  CAS  Google Scholar 

  6. Pour PM, Egami H, Takiyama (1991) Patterns of growth and metastases of induced pancreatic cancer in relation to the prognosis and its clinical implications. Gastroenterology 100:529–536

    PubMed  CAS  Google Scholar 

  7. Allison DC, Bose KK, Hruban RH, Piantadosi S, Dooley WC, Bointnott JK, Cameron JL (1991) Pancreatic cancer cell DNA content correlates with long-term survival after pancreatoduodenectomy. Ann Surg 214:648–656

    PubMed  CAS  Google Scholar 

  8. Nakamori S, Yashima K, Murakami Y, Ishikawa O, Ohigashi H, Imaoka S, Yaegashi S, Konishi S, Sekiya T (1995) Association of p53 gene mutations with short survival in pancreatic adenocarcinoma. Jpn J Cancer Res 86:174–181

    PubMed  CAS  Google Scholar 

  9. Redston MS, Caldas C, Seymour AB, Hruban RH, Costa LD, Yeo CJ, Kern SE (1994) p53 mutations in pancreatic carcinoma and evidence of common involvement of homocopolymer tracts in DNA microdeletions. Cancer Res 54:3025–3033

    PubMed  CAS  Google Scholar 

  10. Finkelstein SD, Przygodzki R, Pricolo VE, Sayegh R, Bakker A, Swalsky PA, Keller G (1994) K-ras-2 topographic genotyping of pancreatic adenocarcinoma. Arch Surg 129:367–373

    PubMed  CAS  Google Scholar 

  11. Japan Pancreatic Society (1996) Classification of pancreatic carcinoma. 1st English edn., Kanehara, Tokyo

    Google Scholar 

  12. Cox DR (1972) Regression models and life-tables. J Stat Soc 34:187–220

    Google Scholar 

  13. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  14. Shimosato Y, Suzuki A, Hashimoto T, Nishiwaki Y, Kodama T, Yoneyama T, Kameya T (1980) Prognostic implications of fibrotic focus (scar) in small peripheral lung cancers. Am J Surg Pathol 4:365–373

    Article  PubMed  CAS  Google Scholar 

  15. Hasebe T, Tsuda H, Hirohashi S, Shimosato Y, Iwai M, Imoto S, Mukai K (1996) Fibrotic focus in invasive ductal carcinoma. An indicator of high aggressiveness. Jpn J Cancer Res 87:385–394

    PubMed  CAS  Google Scholar 

  16. Hasebe T, Tsuda H, Tsubono Y, Imoto S, Mukai K (1997) Fibrotic focus in invasive ductal carcinoma of the breast: A histopathological prognostic parameter for tumor recurrence and tumor death within three years after the initial operation. Jpn J Cancer Res 88:590–599

    PubMed  CAS  Google Scholar 

  17. Hasebe T, Imoto S, Ogura T, Mukai K (1997) Significance of basic fibroblast growth factor and fibroblast growth factor receptor protein expression in the formation of fibrotic focus in invasive ductal carcinoma of the breast. Jpn J Cancer Res (in press)

  18. Tanimoto H, Yoshida K, Yokozaki H, Yasui W, Nakayama H, Ito H, Ohama K, Tahara K (1991) Expression of basic fibroblast growth factor in human gastric carcinomas. Virchows Arch B Cell Pathol 61:263–267

    CAS  Google Scholar 

  19. Lack EE, Steinberg SM, White DE, Kinsella T, Glastein E, Chang AE, Rosenberg SA (1989) Extremity soft tissue sarcomas: analysis of prognostic variables in 300 cases and evaluation of tumor necrosis as a factor in stratifying higher-grade sarcomas. J Surg Oncol 41:263–273

    PubMed  CAS  Google Scholar 

  20. Mandard AM, Petiot JF, Marnay J, Mandard JC, Chasle J, Ranieri E, Dupin P, Herlin P, Ranieri J, Tanguy A, Boulier N, Abbatucci JS (1989) Prognostic factors in soft tissue sarcomas: a multivariate analysis of 109 cases. Cancer 63:1437–1451

    Article  PubMed  CAS  Google Scholar 

  21. Gilchrist KW, Gray R, Fowble B, Tormey DC, Taylor IV SG (1993) Tumor necrosis is a prognostic predictor for early recurrence and death in lymph node-positive breast cancer: a 10-year follow-up study of 728 Eastern Cooperative Oncology Group patients. J Clin Oncol 11:1929–1935

    PubMed  CAS  Google Scholar 

  22. Visscher DW, Wykes S, Kubus J, Crissman JD (1992) Comparison of PCNA/cyclin immunohistochemistry with flow cytometric S-phase fraction in breast cancer. Breast Cancer Res Treat 22:111–118

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Surgery Division, National Cancer Center Hospital East, East 6-5-1 Kashiwanoha, 277, Kashiwa, Japan

    Tetsuya Nakatsura, Munemasa Ryu, Taira Kinoshita, Noriaki Kawano & Masaru Konishi

  2. Pathology Division, National Cancer Center Research Institute, East 6-5-1 Kashiwanoha, 277, Kashiwa, Japan

    Takahiro Hasebe & Kiyoshi Mukai

  3. Epidemiology and Biostatistics Division, National Cancer Center Research Institute, East 6-5-1 Kashiwanoha, 277, Kashiwa, Japan

    Yoshitaka Tsubono

  4. Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, 104, Tokyo, Japan

    Tomoo Kosuge

  5. Pathology Division, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, 104, Tokyo, Japan

    Yae Kanai

Authors
  1. Tetsuya Nakatsura
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  2. Takahiro Hasebe
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  3. Yoshitaka Tsubono
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  4. Munemasa Ryu
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  5. Taira Kinoshita
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  6. Noriaki Kawano
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  7. Masaru Konishi
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  8. Tomoo Kosuge
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  9. Yae Kanai
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  10. Kiyoshi Mukai
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Nakatsura, T., Hasebe, T., Tsubono, Y. et al. Histological prognostic parameters for adenocarcinoma of the pancreatic head. Proposal for a scoring system for prediction of outcome. J Hep Bil Pancr Surg 4, 441–448 (1997). https://doi.org/10.1007/BF02488979

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  • DOI: https://doi.org/10.1007/BF02488979

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