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Poster display session

1676 - Intratumoral heterogeneity of SMAD4 immunohistochemical (IHC) expression and its role in prediction of recurrence patterns in patients with resectable pancreatic cancer (PC)

Date

09 Sep 2017

Session

Poster display session

Topics

Translational Research;  Pancreatic Cancer

Presenters

Ilya Pokataev

Citation

Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369

Authors

I. Pokataev1, A. Kudaibergenova2, A. Artemyeva3, D. Podluzhnyi4, N. Kudashkin4, Y. Patyutko4, E. Moroz5, E. Kharchenko3, A. Popova1, M. Fedyanin1, A. Rumyantsev1, I. Bazin1, A. Tryakin1, E. Glukhov6, O. Sekhina1, D. Chekini1, S. Tjulandin1

Author affiliations

  • 1 Department Of Clinical Pharmacology And Chemotherapy, N. N. Blokhin Russian Cancer Research Center, 115478 - Moscow/RU
  • 2 Department Of Cytology, N. N. Blokhin Russian Cancer Research Center, 115478 - Moscow/RU
  • 3 Department Of Morphology, Petrov Institute of Oncology, Saint Petersburg/RU
  • 4 Department Of Surgery #7, N. N. Blokhin Russian Cancer Research Center, 115478 - Moscow/RU
  • 5 Department Of Morphology, N. N. Blokhin Russian Cancer Research Center, 115478 - Moscow/RU
  • 6 Department Of Surgery, N. N. Blokhin Russian Cancer Research Center, 115478 - Moscow/RU
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Abstract 1676

Background

Up to 30% of patients with resectable PC have only locoregional recurrences and never experience metastatic disease. Several authors reported SMAD4 expression can predict locoregional pattern of PC progression. The aim of our study was to evaluate consistency of SMAD4 expression in different tumor areas and its correlation with patterns of PC recurrence.

Methods

Records of PC patients treated in N.N. Blokhin Russian Cancer Research Center since 2002 to 2015 were analyzed. Inclusion criteria for this retrospective analysis were: nonmetastatic morphologically confirmed PC, R0-R1 resection and archive tumor samples availability. Formalin-fixed, paraffin-embedded tissue sections of different areas of the primary tumor (central area and zones of invasion) and of lymph node metastases were analyzed via IHC for SMAD4 expression using TMA technology.

Results

A total of 356 tissue sections obtained from 91 patients were assessed for SMAD4 expression. Positive SMAD4 expression was revealed in tumor blocks of 26 patients. There was high intratumoral heterogeneity of SMAD4 expression: only in 4 of 26 patients (15.4%) SMAD4 expression was positive in all assessed tumor slides. There were 54 recurrences (9 locoregional, 41 distant and 4 both local and distant) with median follow-up 21.7 months. There were no correlation between SMAD4 expression and locoregional recurrence pattern (Goodman & Kruskal's tau coefficient 0.08±0.03, p = 0,13). There was no difference in distant recurrence-free survival by SMAD4 IHC expression status: medians were 11.8, 19.5 and 7.1 months for patients with SMAD4 negative, heterogeneous or positive tumors, respectively (p = 0.987). SAMD4 status also showed no prognostic significance: medians overall survival were 20.5, 32.6 and 15.2 months for patients with SMAD4-positive, heterogeneous and negative tumors, respectively (p = 0.131).

Conclusions

Different areas inside the primary tumor and lymph node metastases heterogeneously express SMAD4. SMAD4 IHC expression is not a biomarker of a recurrence pattern following surgical resection for PC.

Clinical trial identification

Legal entity responsible for the study

N.N. Blokhin Russian Cancer Research Center

Funding

N.N. Blokhin Russian Cancer Research Center

Disclosure

All authors have declared no conflicts of interest.

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