Resectable pancreatic head adenocarcinoma: Is R0 resection an illusion? Genetic evaluation of venous resection margin affirmed unrecognized disease - 23/08/17
, M. Gilabert b, d, J. Ewald a, V. Moutardier c, J.-R. Delpero a, J.-L. Iovanna dCet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Summary |
Purpose |
To assess the K-ras gene mutation in the histologically negative venous margin of a pancreaticoduodenectomy (PD) specimen and its impact on survival.
Method |
From 2007 to 2010, 22 patients underwent R0 PD for resecable pancreatic adenocarcinoma. All specimens were stained and the portal vein (PV) bed was identified by blue ink; a 2mm3 sample (including the blue ink) was cut from a microscopic free-tumor block. DNA was extracted and assessed by quantitative real time polymerase chain reaction to detect the K-ras gene mutation. Twelve specimens (55%) (kras+ group) were identified with a K-ras mutation in the venous margin resection, and 10 specimens (kras− group) did not have K-ras mutation detected in the venous margin resection.
Results |
The two groups were comparable. Overall 3years survival of patients of kras+ group versus patients of kras− group was 0 and 17% (P=0.03), respectively. Median survival time of patients of kras+ group versus patients of kras− group was 16months vs 25months (P=0.04; 95% confidence interval [1,11–1,88]), respectively.
Conclusion |
Genetic evaluation of venous resection margin affirmed unrecognized disease with strong impact on survival in more than 50% of patients with histologically R0 resection.
Le texte complet de cet article est disponible en PDF.Keywords : Pancreatic cancer, Margins, K-ras gene mutation
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