Long-term survival after radical resection for pancreatic head and ampullary cancer: a potential role for the EGF-R.

Abstract:

BACKGROUND/AIM:Pancreatic cancer has a dismal prognosis. Ampullary cancer (defined as cancer of the ampulla of Vater or the distal common bile duct) has a better prognosis and is thought to be a biologically different tumor. The aim of this study was to find factors that could predict survival after radical (R-0) resection for pancreatic head and ampullary cancers. METHODS:We analyzed clinical and pathological data from 93 patients who underwent a true R-0 resection for pancreatic head or ampullary cancer. Furthermore, we performed a tissue microarray protein expression analysis for several growth factor receptors and oncogenes: HER-2, EGF-R, ER, PR, C-myc, p53, p16, RB-1, and chromogranin A as a neuroendocrine differentiation marker. RESULTS:Median survival (14 vs. 42 months) and time to recurrence (16 vs. 42 months) were significantly longer for ampullary than for pancreatic head cancers. Preoperative pain, perineural invasion, lymph node metastasis, and tumor differentiation grade are indicators of a poor survival. No differences in protein expression were found between groups, except for EGF-R which was expressed more in pancreatic head cancers (p = 0.026). CONCLUSIONS:Outcomes for ampullary cancers are better than for pancreatic head cancers. This different biological behavior can possibly be explained by differences in EGF-R expression.

journal_name

Dig Surg

journal_title

Digestive surgery

authors

Smeenk HG,Erdmann J,van Dekken H,van Marion R,Hop WC,Jeekel J,van Eijck CH

doi

10.1159/000100917

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

38-45

issue

1

eissn

0253-4886

issn

1421-9883

pii

000100917

journal_volume

24

pub_type

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