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Open Access Research article

Evaluation of DNA ploidy in relation with established prognostic factors in patients with locally advanced (unresectable) or metastatic pancreatic adenocarcinoma: a retrospective analysis

Nikolas Tsavaris1*, Nicolaos Kavantzas2, Kostantinos Tsigritis3, Ioannis D Xynos1, Nikitas Papadoniou39, Andreas Lazaris2, Christos Kosmas4, George Agrogiannis2, Anna Dokou1, Evangelos Felekouras3, Efstathios Antoniou5, Aris Polyzos6, John Sarantonis1, Heracles Tsipras7, Gavrilos Karatzas8, Alexandros Papalambros3 and Efstratios S Patsouris2

Author Affiliations

1 Oncology Unit, Department of Pathophysiology, Laikon General Hospital, Athens University School of Medicine, Athens, Greece

2 1st Department of Pathology, Laikon General Hospital, Athens University School of Medicine, Athens, Greece

3 1st Department of Surgery, Laikon General Hospital, Athens University School of Medicine, Athens, Greece

4 2nd Department of Medical Oncology, Metaxa Cancer Hospital, Piraeus, Greece

5 2nd Department of Surgery-Propedeutic, Laikon General Hospital, Athens University School of Medicine, Athens, Greece

6 Oncology Unit, 1st Department of Internal Medicine – Propedeutic, Laikon General Hospital, Athens University School of Medicine, Athens, Greece

7 3rd Department of Surgery, "G. Gennimatas" General Hospital, Athens, Greece

8 3rd Department of Surgery, Attiko Hospital, University of Athens School of Medicine, Athens, Greece

9 Department of Gastrenterology, "Andreas Papandreou" General Hospital, Rhodes, Greece

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BMC Cancer 2009, 9:264  doi:10.1186/1471-2407-9-264

Published: 31 July 2009

Abstract

Background

Most patients with ductal pancreatic adenocarcinoma are diagnosed with locally advanced (unresectable) or metastatic disease. The aim of this study was to evaluate the prognostic significance of DNA ploidy in relation with established clinical and laboratory variables in such patients.

Methods

Two hundred and twenty six patients were studied retrospectively. Twenty two potential prognostic variables (demographics, clinical parameters, biochemical markers, treatment modality) were examined.

Results

Mean survival time was 38.41 weeks (95% c.i.: 33.17–43.65), median survival 27.00 weeks (95% c.i.: 23.18–30.82). On multivariate analysis, 10 factors had an independent effect on survival: performance status, local extension of tumor, distant metastases, ploidy score, anemia under epoetin therapy, weight loss, pain, steatorrhoea, CEA, and palliative surgery and chemotherapy. Patients managed with palliative surgery and chemotherapy had 6.7 times lower probability of death in comparison with patients without any treatment. Patients with ploidy score > 3.6 had 5.0 times higher probability of death in comparison with patients with ploidy score < 2.2 and these with ploidy score 2.2–3.6 had 6.3 times higher probability of death in comparison with patients with ploidy score < 2.2.

Conclusion

According to the significance of the examined factor, survival was improved mainly by the combination of surgery and chemotherapy, and the presence of low DNA ploidy score.