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Stromal progesterone receptor expression and long-term survival in patients with resected periampullary adenocarcinoma

Andersson, G. LU ; Olsson-Hau, S. LU ; Lundgren, S. LU ; Heby, M. LU ; Nodin, B. LU and Jirstrom, K. LU orcid (2018) In Annals of oncology : official journal of the European Society for Medical Oncology 29(Suppl. 8). p.262-263
Abstract
Background: Early trials have reported a beneficial effect from tamoxifen treatment in patients with unresectable pancreatic cancer, in particular in women. However, the presence and prognostic significance of female hormone receptors in pancreatic or other periampullary cancers has not yet been described.

Methods: Immunohistochemical screening of normal and malignant pancreatic tissue revealed that the predominantly expressed female hormone receptor was the progesterone receptor (PgR), in particular in the cancer-associated stroma. The impact of PgR expression on overall survival (OS) was further examined on tissue microarrays with primary tumours from a consecutive retrospective cohort of 175 patients with resected periampullary... (More)
Background: Early trials have reported a beneficial effect from tamoxifen treatment in patients with unresectable pancreatic cancer, in particular in women. However, the presence and prognostic significance of female hormone receptors in pancreatic or other periampullary cancers has not yet been described.

Methods: Immunohistochemical screening of normal and malignant pancreatic tissue revealed that the predominantly expressed female hormone receptor was the progesterone receptor (PgR), in particular in the cancer-associated stroma. The impact of PgR expression on overall survival (OS) was further examined on tissue microarrays with primary tumours from a consecutive retrospective cohort of 175 patients with resected periampullary adenocarcinoma.

Results: Median follow-up time was 29.7 (range 1.9–185.1) months. Stromal PgR positivity (PgR+), allover denoted in 31% of the cases, was significantly higher in pancreatobiliary-type than in intestinal-type tumours (38.7% vs 19.0%, p = 0.008), with an equal distribution between sexes. Stromal PgR+ was significantly associated with a prolonged OS in KRAS-mutated tumours, whereas the opposite was seen in KRAS wild-type tumours (p for interaction =0.015). This association was particularly evident in women, with a median OS of 60.5 months for PgR+/KRAS mutated tumours and 9.9 months for PgR+/KRAS wild-type tumours (p for interaction <0.001). PgR expression was not prognostic in male patients.

Conclusions: The finding of stromal PgR expression, and its link to clinical outcome in a considerable proportion of pancreatic and other periampullary cancers is novel. The concept of tamoxifen treatment for patients with unresectable disease, in particular elderly women, should be pursued, and PgR and KRAS may be relevant biomarkers for improved patient stratification. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of oncology : official journal of the European Society for Medical Oncology
volume
29
issue
Suppl. 8
pages
262 - 263
publisher
Oxford University Press
external identifiers
  • pmid:32136596
ISSN
1569-8041
DOI
10.1093/annonc/mdy282.152
language
English
LU publication?
yes
id
73c74fb3-3e8f-4bd5-b9e0-adbfc485af56
date added to LUP
2020-03-31 13:19:16
date last changed
2024-01-29 02:53:28
@misc{73c74fb3-3e8f-4bd5-b9e0-adbfc485af56,
  abstract     = {{Background: Early trials have reported a beneficial effect from tamoxifen treatment in patients with unresectable pancreatic cancer, in particular in women. However, the presence and prognostic significance of female hormone receptors in pancreatic or other periampullary cancers has not yet been described.<br>
<br>
Methods: Immunohistochemical screening of normal and malignant pancreatic tissue revealed that the predominantly expressed female hormone receptor was the progesterone receptor (PgR), in particular in the cancer-associated stroma. The impact of PgR expression on overall survival (OS) was further examined on tissue microarrays with primary tumours from a consecutive retrospective cohort of 175 patients with resected periampullary adenocarcinoma.<br>
<br>
Results: Median follow-up time was 29.7 (range 1.9–185.1) months. Stromal PgR positivity (PgR+), allover denoted in 31% of the cases, was significantly higher in pancreatobiliary-type than in intestinal-type tumours (38.7% vs 19.0%, p = 0.008), with an equal distribution between sexes. Stromal PgR+ was significantly associated with a prolonged OS in KRAS-mutated tumours, whereas the opposite was seen in KRAS wild-type tumours (p for interaction =0.015). This association was particularly evident in women, with a median OS of 60.5 months for PgR+/KRAS mutated tumours and 9.9 months for PgR+/KRAS wild-type tumours (p for interaction &lt;0.001). PgR expression was not prognostic in male patients.<br>
<br>
Conclusions: The finding of stromal PgR expression, and its link to clinical outcome in a considerable proportion of pancreatic and other periampullary cancers is novel. The concept of tamoxifen treatment for patients with unresectable disease, in particular elderly women, should be pursued, and PgR and KRAS may be relevant biomarkers for improved patient stratification.}},
  author       = {{Andersson, G. and Olsson-Hau, S. and Lundgren, S. and Heby, M. and Nodin, B. and Jirstrom, K.}},
  issn         = {{1569-8041}},
  language     = {{eng}},
  note         = {{Conference Abstract}},
  number       = {{Suppl. 8}},
  pages        = {{262--263}},
  publisher    = {{Oxford University Press}},
  series       = {{Annals of oncology : official journal of the European Society for Medical Oncology}},
  title        = {{Stromal progesterone receptor expression and long-term survival in patients with resected periampullary adenocarcinoma}},
  url          = {{http://dx.doi.org/10.1093/annonc/mdy282.152}},
  doi          = {{10.1093/annonc/mdy282.152}},
  volume       = {{29}},
  year         = {{2018}},
}