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α-Smooth muscle actin expression and desmoplastic stromal reaction in pancreatic cancer : results from the CONKO-001 study . BACKGROUND Previous investigations in pancreatic cancer suggest a prognostic role for α-smooth muscle actin ( α-SMA ) expression and stromal density in the peritumoural stroma . The aim of this study was to further validate the impact of α-SMA expression and stromal density in resectable pancreatic cancer patients treated with adjuvant gemcitabine compared with untreated patients . METHODS CONKO-001 was a prospective randomised phase III study investigating the role of adjuvant gemcitabine as compared with observation . Tissue samples of 162 patients were available for immunohistochemistry on tissue microarrays to evaluate the impact of α-SMA expression and stromal density impact on patient outcome . RESULTS High α-SMA expression in tumour stroma was associated with worse patient outcome ( DFS : P=0.05 , OS : P=0.047 ) . A dense stroma reaction was associated with improved disease-free survival ( DFS ) and overall survival ( OS ) in the overall study population ( DFS : P=0.001 , OS : P=0.001 ) . This positive prognostic impact was restricted to patients with no adjuvant treatment ( DFS : P < 0.001 , OS : P < 0.001 ) . In multivariable analysis , α-SMA and stromal density expression were independently predictive factors for survival . CONCLUSIONS Our data confirm the negative prognostic impact of high α-SMA expression in pancreatic cancer patients after curatively intended resection . In contrast to former investigations , we found a positive prognostic impact for a dense stroma . This significant influence was restricted to patients who received no adjuvant therapy .
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Outcome_Physical
α-Smooth muscle actin expression and desmoplastic stromal reaction
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Outcome_Physical
the impact of α-SMA expression and stromal density impact on patient outcome
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Outcome_Physical
RESULTS High α-SMA expression in tumour stroma
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Outcome_Physical
associated with worse patient outcome
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Outcome_Other
P=0.047
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Outcome_Physical
A dense stroma reaction
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Outcome_Physical
improved disease-free survival ( DFS )
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Outcome_Mortality
overall survival
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Outcome_Adverse-effects
positive prognostic impact
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Outcome_Physical
analysis , α-SMA and stromal density expression
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Outcome_Mortality
factors for survival
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Outcome_Physical
negative prognostic
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Outcome_Physical
positive prognostic
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Participant_Condition
in pancreatic cancer
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Participant_Condition
resectable pancreatic cancer patients treated with
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Participant_Sample-size
162 patients
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Participant_Condition
pancreatic cancer patients