The SMAD4 protein and prognosis of pancreatic ductal adenocarcinoma

Tascilar, Metin, Skinner, Halcyon G., Rosty, Christophe, Sohn, Taylor, Wilentz, Robb E., Offerhaus, G. Johan A., Adsay, Volkan, Abrams, Ross A., Cameron, John L., Kern, Scott E., Yeo, Charles J., Hruban, Ralph H. and Goggins, Michael (2001) The SMAD4 protein and prognosis of pancreatic ductal adenocarcinoma. Clinical Cancer Research, 7 12: 4115-4121.

Author Tascilar, Metin
Skinner, Halcyon G.
Rosty, Christophe
Sohn, Taylor
Wilentz, Robb E.
Offerhaus, G. Johan A.
Adsay, Volkan
Abrams, Ross A.
Cameron, John L.
Kern, Scott E.
Yeo, Charles J.
Hruban, Ralph H.
Goggins, Michael
Title The SMAD4 protein and prognosis of pancreatic ductal adenocarcinoma
Journal name Clinical Cancer Research   Check publisher's open access policy
ISSN 1078-0432; 557-3265
Publication date 2001-12-01
Year available 2001
Sub-type Article (original research)
Open Access Status Not Open Access
Volume 7
Issue 12
Start page 4115
End page 4121
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher American Association for Cancer Research
Language eng
Formatted abstract
Purpose: SMAD4 (also called Dpc4) is a tumor suppressor in the TGF-β signaling1 pathway that is genetically inactivated in ∼55% of all pancreatic adenocarcinomas. We investigated whether prognosis after surgical resection for invasive pancreatic adenocarcinoma is influenced by SMAD4 status.

Experimental Design: Using immunohistochemistry, we characterized the SMAD4 protein status of 249 pancreatic adenocarcinomas resected from patients who underwent pancreaticoduodenectomy (Whipple resection) at The Johns Hopkins Hospital, Baltimore, MD, between 1990 and 1997. The SMAD4 gene status of 56 of 249 (22%) pancreatic carcinomas was also determined. A multivariate Cox proportional hazards model assessed the relative risk of mortality associated with SMAD4 status, adjusting for known prognostic variables.

Results: Patients with pancreatic adenocarcinomas with SMAD4 protein expression had significantly longer survival (unadjusted median survival was 19.2 months as compared with 14.7 months in patients with pancreatic cancers lacking SMAD4 protein expression; P = 0.03). This SMAD4 survival benefit persisted after adjustment for prognostic factors including tumor size, margins, lymph node status, pathological stage, blood loss, and use of adjuvant chemoradiotherapy. The relative hazard of mortality for cancers lacking SMAD4 after adjusting for other prognostic factors was 1.36 (95% confidence interval, 1.01-1.83; P = 0.04).

Conclusion: Patients undergoing Whipple resection for pancreatic adenocarcinoma survive longer if their cancers express SMAD4.
Keyword Oncology
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Thu, 10 Mar 2011, 00:24:04 EST