230P - Prognostic impact of tumoral and/or peri-tumoral SPARC expressions after surgery in patients with biliary tract cancer

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Hepatobiliary Cancers
Translational Research
Surgery and/or Radiotherapy of Cancer
Presenter Daisuke Sakai
Citation Annals of Oncology (2014) 25 (suppl_4): iv58-iv84. 10.1093/annonc/mdu326
Authors D. Sakai1, S. Nakashima2, S. Kobayashi3, M. Konno1, N. Nishida1, T. Kudo1, A. Tomokuni2, Y. Tomimaru2, N. Hama2, H. Wada2, K. Kawamoto2, S. Marubashi2, H. Eguchi2, N. Matsuura4, T. Satoh1, H. Nagano2, Y. Doki2, M. Mori2
  • 1Frontier Science For Cancer And Chemotherapy, Osaka University Graduate School of Medicine, 565-0871 - Suita/JP
  • 2Surgery, Osaka University Graduate School of Medicine, 565-0871 - Suita/JP
  • 3Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 5378511 - Osaka/JP
  • 4President, Osaka Medical Center for Cancer and Cardiovascular Diseases, 5378511 - Osaka/JP

Abstract

Aim

SPARC (secreted protein acidic and rich in cysteine) is a member of matricellular glycoproteins, which modulate interactions between tumoral cells and the peri-tumoral stroma. It was demonstrated that SPARC not only induced proliferation and invasion in vitro, but also became a poor prognostic marker in different cancers, including three gastro-intestinal cancers; stomach, colon, and pancreas. Herein, we evaluated the prognostic significance of tumor and peri-tumoral SPARC expression in patients with biliary tract cancer (BTC) after surgery.

Methods

We examined immunohistochemical patterns of SPARC expression in 110 resected specimens and evaluated the prognostic significance using a prospectively collected database.

Results

93 patients underwent R0 resection, and 54 patients suffered from lymph node metastasis. Overall survival at 5-year after surgery was 34.2%. SPARC expressed at 46 tumoral cells (42%) and at 65 peri-tumoral stroma (59%). Tumoral SPARC did not relate to major patients characteristics; however, peri-tumoral stromal SPARC expressed highly, related to lymph node metastasis, stage, and tumor location. Patients whose peri-tumoral stroma expressed SPARC (MST, 24.5 months) had a significantly worse prognosis than patients whose peri-tumoral stroma did not express SPARC (MST, 69.2 months; p = 0.0001). Moreover, the expression of SPARC in tumoral cells was also associated with a poor prognosis and was a less significantly predictor of prognosis than the positive SPARC expression in peri-tumoral stroma (p = 0.0487). In multivaliate analysis, controlling for other prognostic factors (UICC stage, pathological type, lymph nodes metastasis, margin status, perineural invasion and vascular invasion), the hazard ration for patients whose peri-tumoral stroma expressed SPARC compared with those whose peri-tumoral stroma did not was 2.74 (95% CI, 1.64 to 4.76). The expression of tumoral SPARC was unrelated to an independent predictor of poor prognosis (HR, 1.45; 95% CI, 0.89 to 2.37).

Conclusions

The expression of SPARC at peri-tumoral stroma portends a poor prognosis for patients with BTC after surgery.

Disclosure

All authors have declared no conflicts of interest.