Scientific paperAnalysis of Ki-67 antigen expression, DNA proliferative fraction, and survival in resected cancer of the pancreas
Section snippets
Patient population
Between 1989 and 1994, 43 patients underwent pancreaticoduodenectomy or total pancreatectomy with curative intent for presumed adenocarcinoma of the head of the pancreas at the Indiana University Medical Center. Four patients were ultimately excluded from the analysis after review revealed a nonpancreatic malignancy (3 patients) or proven hepatic metastases at the time of surgery (1 patient). Thus, 39 patients were available for analysis (20 female and 19 male). Archival specimens were
Patient demographics
Table 1summarizes the demographics of patients who had curative resections for cancer of the head of the pancreas. Our previous multivariate analysis revealed only the presence of lymphatic invasion as a statistically significant predictor of poor survival with estimated 5-year survival rates for patients without lymphatic invasion being 23% and with lymphatic invasion being 0% (P = 0.015 by Cox survival analysis) [23]. In the current study, actual overall 2-year survival was 27%, 5-year
Comments
Pancreas cancer has a dismal prognosis with overall 5-year survival rates of well under 5%. Only a small minority of patients benefit from aggressive surgery, attaining at best 20% to 25% predicted 5-year survival. Certain properties of pancreatic tumors themselves, such as tumor size, site, clinical stage, presence of nodal metastases and histologic lymphovascular invasion have been demonstrated to correlate with survival. On the other hand, investigations of operative factors and their
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