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Evaluation of DNA ploidy in relation with established prognostic factors in patients with locally advanced (unresectable) or metastatic pancreatic adenocarcinoma: a retrospective analysis

Author(s): Tsavaris Nikolas | Kavantzas Nicolaos | Tsigritis Kostantinos | Xynos Ioannis | Papadoniou Nikitas | Lazaris Andreas | Kosmas Christos | Agrogiannis George | Dokou Anna | Felekouras Evangelos | Antoniou Efstathios | Polyzos Aris | Sarantonis John | Tsipras Heracles | Karatzas Gavrilos | Papalambros Alexandros | Patsouris Efstratios

Journal: BMC Cancer ISSN 1471-2407
Volume: 9; Issue: 1; Start page: 264; Date: 2009;
Original page

ABSTRACT
Abstract Background Most patients with ductal pancreatic adenocarcinoma are diagnosed with locally advanced (unresectable) or metastatic disease. The aim of this study was to evaluate the prognostic significance of DNA ploidy in relation with established clinical and laboratory variables in such patients. Methods Two hundred and twenty six patients were studied retrospectively. Twenty two potential prognostic variables (demographics, clinical parameters, biochemical markers, treatment modality) were examined. Results Mean survival time was 38.41 weeks (95% c.i.: 33.17–43.65), median survival 27.00 weeks (95% c.i.: 23.18–30.82). On multivariate analysis, 10 factors had an independent effect on survival: performance status, local extension of tumor, distant metastases, ploidy score, anemia under epoetin therapy, weight loss, pain, steatorrhoea, CEA, and palliative surgery and chemotherapy. Patients managed with palliative surgery and chemotherapy had 6.7 times lower probability of death in comparison with patients without any treatment. Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 and these with ploidy score 2.2–3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2. Conclusion According to the significance of the examined factor, survival was improved mainly by the combination of surgery and chemotherapy, and the presence of low DNA ploidy score.