Document Type
Article
Publication Date
10-17-2024
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths in the United States. Previous studies have indicated that microsatellite instability and deficient mismatch repair (MMR) may be associated with improved survival in patients with pancreatic cancer. Here, we aim to investigate the impact of deficient MMR (dMMR) status on oncologic outcomes in patients after resection of PDAC and periampullary adenocarcinoma. Methods: This is a single-institution, retrospective study based on a prospectively maintained database. Pancreatic ductal adenocarcinoma (N = 342) and periampullary adenocarcinoma patients (N = 76) who underwent pancreatic resection surgery between 2016 and 2021 were included. Immunohistochemistry staining results of MMR proteins and next-generation sequencing data were recorded. Cancer-type dependent Cox regression analyses were performed to assess overall and disease-free survival, which was complemented with a 1:2 propensity-score matching for each of the cancer types in order to compare oncologic outcomes. Results: A total of 418 pancreatic cancer patients were included in the analysis. Fifteen patients (3.5%) were diagnosed as dMMR (PDAC N = 7 and periampullary adenocarcinoma N = 8). Cox regression modeling of dMMR status interaction with TNM staging and cancer type revealed that dMMR status strongly improves overall survival (p < 0.05). After propensity-score matching, Cox regression identified dMMR status as a significant marker of improved overall survival (HR = 0.27, 95%CI 0.09–0.88, p = 0.029). Conclusions: Overall, our findings suggest that dMMR status is associated with markedly improved survival outcomes in patients after resection of pancreatic and periampullary cancer. Future large-scale studies are needed to further validate this finding.
Recommended Citation
Prezioso, Elizabeth; Mancheski, Eleanor; Shivok, Kylee; Kaplan, Zachary; Bowne, Wilbur; Jain, Aditi; Lavu, Harish; Yeo, Charles; and Nevler, Avinoam, "Assessing Influence of Mismatch Repair Mutations on Survival in Patients After Resection of Pancreatic Ductal and Periampullary Adenocarcinoma" (2024). Kimmel Cancer Center Faculty Papers. Paper 138.
https://jdc.jefferson.edu/kimmelccfp/138
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
39458133
Language
English
Included in
Digestive System Diseases Commons, Genetic Phenomena Commons, Investigative Techniques Commons, Neoplasms Commons
Comments
This article is the author's final published version in Journal of Clinical Medicine, Volume 13, Issue 20, October 2024, Article number 6185.
The published version is available at https://doi.org/10.3390/jcm13206185.
Copyright © 2024 by the authors