| Clinical significance of dihydropyrimidine dehydrogenase in adjuvant 5-fluorouracil liver perfusion chemotherapy for pancreatic cancer. | |
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MedLine Citation:
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PMID: 15492566 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To clarify the relationship between intratumoral dihydropyrimidine dehydrogenase (DPD) expression and response to 5-fluorouracil (5-FU) liver perfusion chemotherapy (LPC) in pancreatic cancer patients, we evaluated DPD expression immunohistochemically in resected pancreatic cancer tissues. SUMMARY BACKGROUND DATA: Pancreatic cancer is considered a disease with a poor prognosis even if aggressive resection is performed. One of the main causes of death is hepatic metastasis soon after surgery. As a treatment, we have assessed adjuvant LPC via the portal vein using 5-FU just after pancreatectomy for advanced pancreatic cancer since 1994. However, the results remain unsatisfying. METHODS: Sixty-eight resected specimens were obtained from patients with pancreatic cancer from 1988 to 2000. Formalin-fixed paraffin-embedded tissues were immunostained with polyclonal anti-DPD antibody. The relation between intratumoral DPD expression and the prognoses of pancreatic cancer patients was investigated statistically. RESULTS: Of the 68 tumors studied, 27 carcinomas (39.7%) were DPD(+), and 41 (60.3%) were DPD(-). In the DPD(+) group, there was no significant difference between the LPC(+) and LPC(-) subgroups, whereas in the DPD(-) group the LPC(+) subgroup showed a significantly higher survival rate than the LPC(-) subgroup. Moreover, in the LPC(+) group, overall survival in the DPD(-) subgroup was significantly better than in the DPD(+) subgroup. CONCLUSIONS: An immunohistochemical evaluation of intratumoral DPD expression might be useful in predicting responsiveness to 5-FU-based chemotherapy in pancreatic cancer patients. In the DPD(-) group, liver perfusion chemotherapy using 5-FU via the portal vein is effective adjuvant therapy for pancreatic cancer once pancreatectomy has been performed. |
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Authors:
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Shigeki Nakayama; Shin Takeda; Yoshihisa Kawase; Soichiro Inoue; Tetsuya Kaneko; Akimasa Nakao |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of surgery Volume: 240 ISSN: 0003-4932 ISO Abbreviation: Ann. Surg. Publication Date: 2004 Nov |
Date Detail:
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Created Date: 2004-10-19 Completed Date: 2004-11-23 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
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Languages: eng Pagination: 840-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery II, Nagoya University School of Medicine, Nagoya, Japan. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Antimetabolites, Antineoplastic
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administration & dosage* Chemotherapy, Adjuvant Chemotherapy, Cancer, Regional Perfusion* Dihydrouracil Dehydrogenase (NADP) / analysis* Female Fluorouracil / administration & dosage* Humans Immunohistochemistry Liver Circulation Liver Neoplasms / prevention & control, secondary Male Middle Aged Pancreatectomy Pancreatic Neoplasms / drug therapy*, enzymology, mortality, pathology Portal Vein Prognosis Survival Rate |
| Chemical | |
Reg. No./Substance:
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0/Antimetabolites, Antineoplastic; 51-21-8/Fluorouracil; EC 1.3.1.2/Dihydrouracil Dehydrogenase (NADP) |
| Comments/Corrections | |
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