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Author Colbert, Lauren E. ♦ Fisher, Sarah B. ♦ Balci, Serdar ♦ Saka, Burcu ♦ Chen, Zhengjia ♦ Kim, Sungjin ♦ El-Rayes, Bassel F. ♦ Adsay, N. Volkan ♦ Maithel, Shishir K. ♦ Landry, Jerome C.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword RADIOLOGY AND NUCLEAR MEDICINE ♦ ANIMAL TISSUES ♦ ANOXIA ♦ CARCINOMAS ♦ CHEMOTHERAPY ♦ MULTIVARIATE ANALYSIS ♦ PANCREAS ♦ PATIENTS ♦ RADIOTHERAPY ♦ REGRESSION ANALYSIS ♦ SPECIFICITY
Abstract Purpose: To evaluate nuclear hypoxia-inducible factor 1α (HIF-1α) expression as a prognostic factor for distant recurrence (DR) and local recurrence (LR) after pancreatic adenocarcinoma resection. Methods and Materials: Tissue specimens were collected from 98 patients with pancreatic adenocarcinoma who underwent resection without neoadjuvant therapy between January 2000 and December 2011. Local recurrence was defined as radiographic or pathologic evidence of progressive disease in the pancreas, pancreatic bed, or associated nodal regions. Distant recurrence was defined as radiographically or pathologically confirmed recurrent disease in other sites. Immunohistochemical staining was performed and scored by an independent pathologist blinded to patient outcomes. High HIF-1α overall expression score was defined as high percentage and intensity staining and thus score >1.33. Univariate analysis was performed for HIF-1α score with LR alone and with DR. Multivariate logistic regression was used to determine predictors of LR and DR. Results: Median follow-up time for all patients was 16.3 months. Eight patients (8%) demonstrated isolated LR, 26 patients (26.5%) had isolated DR, and 13 patients had both LR and DR. Fifty-three patients (54%) had high HIF-1α expression, and 45 patients (46%) had low HIF-1α expression. High HIF-1α expression was significantly associated with DR (P=.03), and low HIF-1α expression was significantly associated with isolated LR (P=.03). On multivariate logistic regression analysis, high HIF-1α was the only significant predictor of DR (odds ratio 2.46 [95% confidence interval 1.06-5.72]; P=.03). In patients with a known recurrence, an HIF-1α score ≥2.5 demonstrated a specificity of 100% for DR. Conclusions: High HIF-1α expression is a significant predictor of distant failure versus isolated local failure in patients undergoing resection of pancreatic adenocarcinoma. Expression of HIF-1α may have utility in determining candidates for adjuvant local radiation therapy and systemic chemotherapy.
ISSN 03603016
Educational Use Research
Learning Resource Type Article
Publisher Date 2015-03-01
Publisher Place United States
Journal International Journal of Radiation Oncology, Biology and Physics
Volume Number 91
Issue Number 3


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