Evidence map›Paper›PMID 26716653›Full record

ArticleOncotarget2016

The prognostic role of desmoplastic stroma in pancreatic ductal adenocarcinoma.

Lai Mun Wang, Michael A Silva, Zenobia D'Costa, Robin Bockelmann, Zahir Soonawalla, Stanley Liu, Eric O'Neill, Somnath Mukherjee, W Gillies McKenna, Ruth Muschel and 1 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Oncotarget, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed
3.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 112 citations in OpenAlex.

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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Lai Mun WangDepartment of Pathology, Oxford University Hospital NHS Trust, University of Oxford, Oxford, UK.
Michael A SilvaDepartment of Surgery, Oxford University Hospital NHS Trust, Oxford, UK.
Zenobia D'CostaDepartment of Oncology, CRUK/MRC Institute for Radiation Oncology, University of Oxford, Oxford, UK.
Robin BockelmannDepartment of Oncology, CRUK/MRC Institute for Radiation Oncology, University of Oxford, Oxford, UK.
Zahir SoonawallaDepartment of Surgery, Oxford University Hospital NHS Trust, Oxford, UK.
Stanley LiuDepartment of Radiation Oncology, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Eric O'NeillDepartment of Oncology, CRUK/MRC Institute for Radiation Oncology, University of Oxford, Oxford, UK.
Somnath MukherjeeDepartment of Oncology, CRUK/MRC Institute for Radiation Oncology, University of Oxford, Oxford, UK.
W Gillies McKennaDepartment of Oncology, CRUK/MRC Institute for Radiation Oncology, University of Oxford, Oxford, UK.
Ruth MuschelDepartment of Oncology, CRUK/MRC Institute for Radiation Oncology, University of Oxford, Oxford, UK.
Emmanouil FokasDepartment of Oncology, CRUK/MRC Institute for Radiation Oncology, University of Oxford, Oxford, UK.
CRUK/MRC Oxford Institute for Radiation Oncology · GBOxford University Hospitals NHS Trust · GBUniversity of Oxford · GBSunnybrook Health Science Centre · CA

Funding

Cancer Research UK 19277Cancer Research UK 20407Medical Research Council MC_PC_12004
6 · The paper itself

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an abundant desmoplastic stroma. We examined the prognostic value of stroma density and activity in patients with resectable PDAC treated with surgery and adjuvant gemcitabine-based chemotherapy. FFPE-tissue from the pancreatectomy of 145 patients was immunohistochemically stained for haematoxylin-eosin and Masson's trichrome to assess stroma density, and alpha-smooth muscle actin (αSMA) expression for activated pancreatic stellate cells. Their expression was correlated with clinicopathological characteristics as well as overall survival (OS), progression-free survival (PFS), local progression-free survival (LPFS) and distant metastases free-survival (DMFS). After a mean follow-up of 20 months (range, 2-69 months), the median OS was 21 months and the 3-year OS was 35.7%. In multivariate analysis, highly-dense stroma was an independent prognostic parameter for OS (p = 0.001), PFS (p = 0.007), LPFS (p = 0.001) and DMFS (p = 0.002), while αSMA expression lacked significance. Interestingly, highly-dense stroma retained significance for the four clinical endpoints only in early (pT1-2) but not late (pT3-4) stage tumors. Additionally, late pT-stage (pT3-4), the presence of lymph node metastases (pN+ vs pN0), perineural/neural invasion and administration of adjuvant chemotherapy also correlated with prognosis in multivariate analysis. Altogether, stroma density constitutes an independent prognostic marker in PDAC patients treated with adjuvant chemotherapy. Our findings highlight the dynamic complexity of desmoplasia and indicate that highly-dense stroma is correlated with better outcome. Further validation of the prognostic value of stroma as a biomarker and its role in PDAC patients after adjuvant chemotherapy is warranted and will be performed in a prospective study.

Indexed as

AgedAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalCombined Modality TherapyFemaleFollow-Up StudiesHumansLymphatic MetastasisMaleNeoplasm GradingNeoplasm InvasivenessNeoplasm StagingPancreatectomyPancreatic NeoplasmsPrognosisStromal Cellsdesmoplasiapancreatic cancerprognosisstroma densityαSMA

Identifiers

PMID26716653
PMCPMC4826198
OpenAlexW2261461400

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.