The management strategy of pancreatic cancer in the era of systemic therapy—“Surgery First” or “Surgery Last”?

Yang, Yinmo; Tian, Xiaodong

doi:10.21037/hbsn-22-146

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…However, even after radical resection, patients with PDAC still face a dismal prognosis, with a 5-year overall survival (OS) rate of approximately 20% [1][2][3][4][5] . The poor postoperative prognosis of patients with PDAC is attributed to the advanced stage of most tumors at diagnosis and is closely associated with these tumors' aggressive biological behavior [6][7][8] . Precise histological grading of PDAC according to its biological behavior has immense value in predicting prognosis, guiding treatment decisions, and monitoring recurrence.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of grade of malignancy based on histopathological differentiation and Ki-67 in pancreatic ductal adenocarcinoma

Liang,

Sheng,

Guo

et al. 2024

Cancer Biol Med

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Objective: Tumor cell malignancy is indicated by histopathological differentiation and cell proliferation. Ki-67, an indicator of cellular proliferation, has been used for tumor grading and classification in breast cancer and neuroendocrine tumors. However, its prognostic significance in pancreatic ductal adenocarcinoma (PDAC) remains uncertain. Methods: Patients who underwent radical pancreatectomy for PDAC were retrospectively enrolled, and relevant prognostic factors were examined. Grade of malignancy (GOM), a novel index based on histopathological differentiation and Ki-67, is proposed, and its clinical significance was evaluated. Results: The optimal threshold for Ki-67 was determined to be 30%. Patients with a Ki-67 expression level > 30% rather than ≤ 30% had significantly shorter 5-year overall survival (OS) and recurrence-free survival (RFS). In multivariate analysis, both histopathological differentiation and Ki-67 were identified as independent prognostic factors for OS and RFS. The GOM was used to independently stratify OS and RFS into 3 tiers, regardless of TNM stage and other established prognostic factors. The tumor-node-metastasis-GOM stage was used to stratify survival into 5 distinct tiers, and surpassed the predictive performance of TNM stage for OS and RFS. Conclusions: Ki-67 is a valuable prognostic indicator for PDAC. Inclusion of the GOM in the TNM staging system may potentially enhance prognostic accuracy for PDAC.

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