Sam C Wang1, Justin R Parekh2, Matthew R Porembka2, Hari Nathan3, Michael I D'Angelica4, Ronald P DeMatteo4, Yuman Fong5, T Peter Kingham4, William R Jarnagin4, Peter J Allen4. 1. Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA. sam.wang@utsouthwestern.edu. 2. Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA. 3. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. 4. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 5. Department of Surgery, City of Hope Medical Center, Duarte, CA, USA.
Abstract
BACKGROUND: Current preoperative risk stratification modalities for pancreatic ductal adenocarcinoma (PDA) patients are inadequate. Elevated serum matrix metalloproteinase 7 (MMP7) is associated with metastatic PDA. We evaluated preoperative MMP7 level as a prognostic marker in patients with resectable PDA. METHODS: From a prospectively maintained database, we identified PDA patients who underwent operation with curative intent from 2004 to 2008 and had serum collected preoperatively. MMP7 was measured by enzyme-linked immunosorbent assay. Patients were defined as having advanced disease if they were found to be unresectable at the time of operation or had nodal involvement on final pathology. RESULTS: Preoperative serum samples were available for 134 patients. Using a cutoff of 13.5 ng/mL, MMP7 was highly predictive for advanced disease. For patients who underwent R0 resection, MMP7 > 13.5 ng/mL was strongly associated with N1 status, T3/T4 stage, moderate/poor differentiation, and perineural invasion. The median recurrence-free survival was 5.0 months in patients with MMP7 > 13.5 ng/mL versus 9.9 months for patients with lower values (P = 0.004). CONCLUSIONS: Very elevated serum MMP7 was highly predictive of unresectable disease and nodal involvement despite favorable preoperative cross-sectional imaging. MMP7 should be further evaluated as a biomarker to risk-stratify PDA patients prior to operation.
BACKGROUND: Current preoperative risk stratification modalities for pancreatic ductal adenocarcinoma (PDA) patients are inadequate. Elevated serum matrix metalloproteinase 7 (MMP7) is associated with metastatic PDA. We evaluated preoperative MMP7 level as a prognostic marker in patients with resectable PDA. METHODS: From a prospectively maintained database, we identified PDApatients who underwent operation with curative intent from 2004 to 2008 and had serum collected preoperatively. MMP7 was measured by enzyme-linked immunosorbent assay. Patients were defined as having advanced disease if they were found to be unresectable at the time of operation or had nodal involvement on final pathology. RESULTS: Preoperative serum samples were available for 134 patients. Using a cutoff of 13.5 ng/mL, MMP7 was highly predictive for advanced disease. For patients who underwent R0 resection, MMP7 > 13.5 ng/mL was strongly associated with N1 status, T3/T4 stage, moderate/poor differentiation, and perineural invasion. The median recurrence-free survival was 5.0 months in patients with MMP7 > 13.5 ng/mL versus 9.9 months for patients with lower values (P = 0.004). CONCLUSIONS: Very elevated serum MMP7 was highly predictive of unresectable disease and nodal involvement despite favorable preoperative cross-sectional imaging. MMP7 should be further evaluated as a biomarker to risk-stratify PDApatients prior to operation.
Entities:
Keywords:
Biomarker; CA19-9; MMP7; Pancreas cancer
Authors: Ivo Meinhold-Heerlein; Dirk Bauerschlag; Yingyao Zhou; Lisa M Sapinoso; Keith Ching; Henry Frierson; Karen Bräutigam; Jalid Sehouli; Elmar Stickeler; Dominique Könsgen; Felix Hilpert; Constantin S von Kaisenberg; Jacobus Pfisterer; Thomas Bauknecht; Walter Jonat; Norbert Arnold; Garret M Hampton Journal: Clin Cancer Res Date: 2007-01-15 Impact factor: 12.531
Authors: Tibor Szarvas; Markus Becker; Frank Vom Dorp; Jan Meschede; André Scherag; Agnes Bánkfalvi; Henning Reis; Kurt W Schmid; Imre Romics; Herbert Rübben; Süleyman Ergün Journal: Int J Cancer Date: 2011-03-15 Impact factor: 7.396
Authors: Jordan M Winter; Murray F Brennan; Laura H Tang; Michael I D'Angelica; Ronald P Dematteo; Yuman Fong; David S Klimstra; William R Jarnagin; Peter J Allen Journal: Ann Surg Oncol Date: 2011-07-15 Impact factor: 5.344
Authors: Tibor Szarvas; Markus Becker; Frank vom Dorp; Carolin Gethmann; Martin Tötsch; Agnes Bánkfalvi; Kurt W Schmid; Imre Romics; Herbert Rübben; Süleyman Ergün Journal: Cancer Sci Date: 2010-01-20 Impact factor: 6.716
Authors: Azizbek Ramankulov; Michael Lein; Manfred Johannsen; Mark Schrader; Kurt Miller; Klaus Jung Journal: Cancer Sci Date: 2008-04-14 Impact factor: 6.716
Authors: Skye C Mayo; Donald F Austin; Brett C Sheppard; Motomi Mori; Donald K Shipley; Kevin G Billingsley Journal: J Am Coll Surg Date: 2009-01 Impact factor: 6.113
Authors: Rebekah White; Corrine Winston; Mithat Gonen; Michael D'Angelica; William Jarnagin; Yuman Fong; Kevin Conlon; Murray Brennan; Peter Allen Journal: J Am Coll Surg Date: 2007-11-26 Impact factor: 6.113
Authors: Linda M Pak; Mithat Gonen; Kenneth Seier; Vinod P Balachandran; Michael I D'Angelica; William R Jarnagin; T Peter Kingham; Peter J Allen; Richard K G Do; Amber L Simpson Journal: Abdom Radiol (NY) Date: 2018-08
Authors: Blendi Ura; Valeria Capaci; Michelangelo Aloisio; Giovanni Di Lorenzo; Federico Romano; Giuseppe Ricci; Lorenzo Monasta Journal: Biomedicines Date: 2022-08-02
Authors: Sami Shoucair; Jianan Chen; James R Martinson; Joseph R Habib; Benedict Kinny-Köster; Ning Pu; A Floortje van Oosten; Ammar A Javed; Eun Ji Shin; Syed Z Ali; Kelly J Lafaro; Christopher L Wolfgang; Jin He; Jun Yu Journal: JAMA Surg Date: 2022-07-13 Impact factor: 16.681
Authors: Jian Zheng; Jonathan M Hernandez; Alexandre Doussot; Linda Bojmar; Constantinos P Zambirinis; Bruno Costa-Silva; Elke J A H van Beek; Milica T Mark; Henrik Molina; Gokce Askan; Olca Basturk; Mithat Gonen; T Peter Kingham; Peter J Allen; Michael I D'Angelica; Ronald P DeMatteo; David Lyden; William R Jarnagin Journal: HPB (Oxford) Date: 2018-01-12 Impact factor: 3.647