ArticleInternational journal of radiation oncology, biology, physics2026
High SMAD4 Expression is Associated with Improved Clinical Outcomes in Patients with Resectable Pancreatic Cancer: An Analysis of NRG Oncology/RTOG 9704.
Article in International journal of radiation oncology, biology, physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
Abstract
purposeThe SMAD4 transcription factor mediates TGF-β signal transduction and is frequently inactivated in pancreatic cancer (PC). This study evaluated SMAD4 (protein) expression in the NRG Oncology/RTOG 9704 phase III trial comparing post-operative chemotherapy-chemoradiation combination regimens for resectable PC. It is hypothesized that higher SMAD4 expression correlates with lower distant metastasis (DM) and improved overall survival (OS). MATERIALS AND
methodsQuantitative multiplexed SMAD4 immunofluorescence analysis was performed in pan-cytokeratin positive tumor samples from resected specimens. Total cellular SMAD4 analysis was dichotomized by the median (low: <median, high: ≥median). Disease-free survival (DFS) and OS were evaluated by Kaplan-Meier methods and log-rank tests. Local-regional recurrence (LRR) and DM were assessed via cumulative incidence and Gray's tests. SMAD4-outcome associations were evaluated by univariate and multivariable Cox proportional hazards or Fine-Gray regression models.
resultsFor 141 analyzable patients, baseline characteristics remained similar with and without SMAD4 quantitation and between low and high SMAD4 groupings. High SMAD4 expression was associated with better DFS (32% risk reduction of DFS failure [HR (95% CI): 0.68 (0.48, 0.97); p=0.03]), improved OS (31% risk reduction of death [HR (95% CI): 0.69 (0.48, 0.99); p=0.04]), and lower DM rates [HR (95% CI): 0.69 (0.48, 0.99), p=0.048], but not LRR. Multivariable analysis confirmed correlations between high SMAD4 and better DFS [HR (95% CI): 0.66 (0.46, 0.96), p=0.03] and lower DM rate [HR (95% CI): 0.68 (0.46, 1.004), p=0.052].
conclusionsSMAD4 expression is significantly associated with lower DM and higher DFS and OS in tumor samples from a large, prospectively randomized trial of resectable PC.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.