Evidence map›Paper›PMID 39703529›Full record

ArticleOncology letters2025

Intratumoural expression of dihydropyrimidine dehydrogenase is an independent prognostic factor in resected pancreatic ductal adenocarcinoma treated with adjuvant gemcitabine.

Hakon Blomstrand, Malin Bodarve, Fredrik Groth, Peter Naredi, Malin Sund, Caroline Vilhav, Henrik Green, Bergthor Björnsson, Daniel Öhlund, Stina Lindblad and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Oncology letters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

12 authors.

Hakon BlomstrandDivision of Surgery, Orthopaedics and Oncology, Department of Biomedical and Clinical Sciences, Linköping University, SE-58185 Linköping, Sweden.
Malin BodarveDepartment of Clinical Pathology, Linköping University Hospital, SE-58185 Linköping, Sweden.
Fredrik GrothDepartment of Clinical Pathology, Linköping University Hospital, SE-58185 Linköping, Sweden.
Peter NarediDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE-40530 Gothenburg, Sweden.
Malin SundDepartment of Diagnostics and Intervention, Umeå University, SE-90187 Umeå, Sweden.
Caroline VilhavDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE-40530 Gothenburg, Sweden.
Henrik GreenDivision of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, SE-58185 Linköping, Sweden.
Bergthor BjörnssonDivision of Surgery, Orthopaedics and Oncology, Department of Biomedical and Clinical Sciences, Linköping University, SE-58185 Linköping, Sweden.
Daniel ÖhlundDepartment of Diagnostics and Intervention, and Wallenberg Centre for Molecular Medicine, Umeå University, SE-90187 Umeå, Sweden.
Stina LindbladDepartment of Diagnostics and Intervention, and Wallenberg Centre for Molecular Medicine, Umeå University, SE-90187 Umeå, Sweden.
Oskar FranklinDepartment of Diagnostics and Intervention, Umeå University, SE-90187 Umeå, Sweden.
Nils O ElanderDivision of Surgery, Orthopaedics and Oncology, Department of Biomedical and Clinical Sciences, Linköping University, SE-58185 Linköping, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is associated with a poor prognosis, and biomarkers to guide treatment decisions in PDAC are generally lacking. Intratumoural expression of dihydropyrimidine dehydrogenase (DPD) is a potential prognostic parameter in patients with PDAC undergoing surgical resection and postoperative chemotherapy. In the present study, DPD was analysed by immunohistochemistry of a tissue microarray platform including a real-world cohort of 495 patients with PDAC who had undergone resection with curative intent at any of three tertiary centres, including Northern, Western and Southeastern regions of Sweden, between 1993 and 2019. DPD level (high/low) was analysed and overall survival associations were assessed in treatment subgroups using a multivariate Cox regression model accounting for potential confounders. In patients who had not received adjuvant chemotherapy (n=182), the median overall survival time was 11.6 months (95% CI 9.6-13.5), compared with 28.8 months (25.0-32.6) among those who had (n=313; log-rank P<0.001). The most common type of chemotherapy was gemcitabine single agent (Gem, n=239) followed by gemcitabine plus capecitabine (GemCape, n=39). Tumour-Node-Metastasis (TNM) stage and DPD expression were statistically significant prognostic parameters in the Gem group (HR 1.19, 95% CI 1.01-1.41, P=0.036), with high expression of DPD linked with worse survival. In addition, tumour grade and TNM stage were statistically significant prognostic factors in the group that did not receive any chemotherapy (P≤0.001). No statistically significant parameters were identified in the GemCape group. Taken together, intratumoural expression of DPD may be considered a prognostic marker for patients with PDAC treated with adjuvant gemcitabine following surgical resection, with low expression levels predicting better survival. Further studies in larger cohorts of patients receiving multi-drug or non-gemcitabine based regimens are warranted.

Indexed as

adjuvant chemotherapydihydropyrimidine dehydrogenasegemcitabinepancreatic cancerpancreatic ductal carcinomaprognosisprognostic factors

Identifiers

PMID39703529
PMCPMC11656693

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