Z Gastroenterol 2019; 57(09): e314
DOI: 10.1055/s-0039-1695443
Gastroenterologische Onkologie
Pankreaskarzinom: Molekular – Prognose: Freitag, 04. Oktober 2019, 15:05 – 16:41, Studio Terrasse 2.2 A
Georg Thieme Verlag KG Stuttgart · New York

Survivin expression in the Pancreatic Ductal Adenocarcinoma

SA Safi
1   Universitätsklinikum Düsseldorf, Abteilung für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf, Deutschland
,
L Haeberle
2   Universitätsklinikum Düsseldorf, Institut für Pathologie, Düsseldorf, Deutschland
,
S Babaei
1   Universitätsklinikum Düsseldorf, Abteilung für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf, Deutschland
,
L Dizdar
1   Universitätsklinikum Düsseldorf, Abteilung für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf, Deutschland
,
WT Knoefel
1   Universitätsklinikum Düsseldorf, Abteilung für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf, Deutschland
,
A Krieg
1   Universitätsklinikum Düsseldorf, Abteilung für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
13 August 2019 (online)

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    Background:

    Survival after pancreatic surgery for the PDAC is poor and remained unchanged over the last decades despite improvements in surgical care and modified chemotherapeutic regimes. It is estimated to become the second leading cause of cancer-related deaths by 2030. Therefore, the identification of biomarkers that can be antagonized by targeted therapy may lead to novel encouraging treatment options. Survivin, one of the key regulators of mitosis and apoptosis, has long been well recognized to play important biological roles in many neoplasms However, its prognostic value in PDAC remains controversial.

    Methods:

    286 consecutive patients with surgically resected and histologically confirmed PDAC of the pancreas were included in this study. Clinicopathological data were analyzed in a prospective maintained database. Histopathologic reports were re-assessed to the 8th UICC edition. Tissue microarrays were constructed to assess the relationship between inhibitor of apoptosis protein (IAP) survivin expression levels and clinicopathological variables, overall and disease free survival (OS, DFS), as well as sight of metachronous metastases.

    Results:

    Nuclear and cytoplasmatic survivin expression (N.SVE, C.SVE) were much higher in tumor (center and invasionfront) and LN metatases compared to normal pancreas tissues (P < 0,001). SVE in tumor tissue correlated significantly with T-stage, M-stage and positive perineural invasion. In univariate survival analysis, higher patient age, M1-, V1- and R1- status correlated with poor OS. In multivariate analysis, only higher patient age and R1-status were independent prognostic markers. In subgroup analysis of all R0 resected patients and in patients with a PDAC of the pancreas tail, higher SVE in tumor was correlated with poor OS in univariate analysis respectively (p = 0,025 and 0,007). Higher N.SVE in Tumor was correlated with poor DFS in all patients in multivariate Analysis.

    Conclusions:

    Survivin demonstrates distinct expression patterns in PDAC, which are associated with advanced disease. In univariate analysis survivin was a prognostic marker for OS, whereas higher SVE in tumor was an independent prognostic marker fot DFS. We thus provide evidence that Survivin might serve as viable target in patients with PDAC.


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