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Advanced Pancreatic Ductal Cancer: Fibrotic Focus and &bgr;-Catenin Expression Correlate With Outcome

Introduction Many investigators have examined prognostic factors for advanced pancreatic ductal cancer, but it is still difficult to accurately predict the outcome of the disease. Aim To examine correlation between histopathologic factors and outcome of advanced ductal carcinoma of the pancreas. Methodology The subjects were 23 patients who underwent resection of pancreatic ductal cancer classified as stage III according to pTNM classification. Fibrotic focus (which is evidence of intratumoral fibroblast proliferation), tumor size and differentiation, invasion to the portal vein, and immunohistologic expression of E-cadherin and &agr;-, &bgr;- andbgr;- and &ggr;-catenins were evaluated. Correlation between histologic and immunohistologic data and correlation between these data and liver metastasis–free survival and overall survival were assessed by means of the Kaplan–Meier method, the log-rank test, and the Cox proportional hazards regression model (for multivariate analysis). Results The presence of fibrotic focus correlated with reduced membranous &bgr;-catenin expression. The presence of fibrotic focus, reduced membranous &bgr;-catenin expression, and reduced cytoplasmic &agr;-catenin expression were significantly associated with shorter liver metastasis–free survival. The presence of fibrotic focus also significantly correlated with shorter survival and was the only factor significantly associated with survival in multivariate analysis. Conclusion The presence of fibrotic focus and reduced &bgr;-catenin expression closely correlated with poor survival of patients with advanced ductal carcinoma of the pancreas.