ArticleThe journal of pathology. Clinical research2023
Post-operative mortality and recurrence patterns in pancreatic cancer according to KRAS mutation and CDKN2A, p53, and SMAD4 expression.
Article in The journal of pathology. Clinical research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 23 citations in OpenAlex.
- Prognostic model for pancreatic cancer based on machine learning of routine slides and transcriptomic tumor analysis.British journal of cancer · 2026Article
- Prognostic Implications of Codon-SpecificJCO precision oncology · 2026Article
- The Multi-Target lncRNA-miRNA-mRNA TRIAD in Pancreatic Cancer Diagnosis and Therapy.International journal of molecular sciences · 2026Review
- Research progress on the etiology and pathogenesis of pancreatic cancer: a narrative review.Frontiers in oncology · 2026Review
- Mechanistic insights into hepatic metastasis of pancreatic cancer: molecular perspectives.Translational gastroenterology and hepatology · 2026Review
- Blood Group Antigen Expression in Blood and Tumor in Relation to Survival Outcomes in Resected Pancreatic Cancer, Overall and by Adjuvant Chemotherapy Regimens.Annals of surgical oncology · 2025Article
- Drivers of Pancreatic Cancer: Beyond the Big 4.Cancers · 2025Review
- Tumor-stroma ratio combined with PD-L1 identifies pancreatic ductal adenocarcinoma patients at risk for lymph node metastases.British journal of cancer · 2025Article
- Preoperative Prognostic Factors in Resectable Pancreatic Cancer: State of the Art and Prospects.Annals of surgical oncology · 2025Review
- A lipid metabolism related gene signature predicts postoperative recurrence in pancreatic cancer through multicenter cohort validation.Scientific reports · 2025Article
- Clinical utility of comprehensive genomic profiling for advanced pancreatic cancer: insights from real-world data analysis.International journal of clinical oncology · 2025Article
- Harnessing Plant Flavonoids to Fight Pancreatic Cancer.Current nutrition reports · 2024Review
- PRMT1 Sustains De Novo Fatty Acid Synthesis by Methylating PHGDH to Drive Chemoresistance in Triple-Negative Breast Cancer.Cancer research · 2024Article
- Significance of TP53, CDKN2A, SMAD4 and KRAS in Pancreatic Cancer.Current issues in molecular biology · 2024Review
- CDKN2A promoter methylation enhances self-renewal of glioblastoma stem cells and confers resistance to carmustine.Molecular biology reports · 2024Article
- Integrative Analysis of TLS-Associated Gene Signatures, Immune Infiltration and Drug Sensitivity in Pancreatic Cancer.IET systems biologyArticle
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Authors and funding
25 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Alterations in KRAS, CDKN2A (p16), TP53, and SMAD4 genes have been major drivers of pancreatic carcinogenesis. The clinical course of patients with pancreatic cancer in relation to these driver alterations has not been fully characterised in large populations. We hypothesised that pancreatic carcinomas with different combinations of KRAS mutation and aberrant expression of CDKN2A, p53, and SMAD4 might show distinctive recurrence patterns and post-operative survival outcomes. To test this hypothesis, we utilised a multi-institutional cohort of 1,146 resected pancreatic carcinomas and assessed KRAS mutations by droplet digital polymerase chain reaction and CDKN2A, p53, and SMAD4 expression by immunohistochemistry. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for disease-free survival (DFS) and overall survival (OS) were computed according to each molecular alteration and the number of altered genes using the Cox regression models. Multivariable competing risks regression analyses were conducted to assess the associations of the number of altered genes with specific patterns of recurrence. Loss of SMAD4 expression was associated with short DFS (multivariable HR, 1.24; 95% CI, 1.09-1.43) and OS times (multivariable HR, 1.27; 95% CI, 1.10-1.46). Compared to cases with 0-2 altered genes, cases with three and four altered genes had multivariable HRs for OS of 1.28 (95% CI, 1.09-1.51) and 1.47 (95% CI, 1.22-1.78), respectively (p
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