COMMENTARY
Pancreatic cancer
An unfavourable prognosis for pancreatic cancer indicates fields of opportunity
Correspondence to:
Correspondence to:
Dr W Greenhalf
Division of Surgery and Oncology, 5th Floor UCD Building, Daulby St, Liverpool L69 3GA, UK; greenhaf@liverpool.ac.uk
Large fields of cancerisation may give more aggressive, but easier to detect, pancreatic ductal adenocarcinoma
Keywords: K-ras; pancreatic cancer; surgical margin; resection margins; field cancerisation
| The first 150 words of the full text of this article appear below. |
Prognosis for patients with pancreatic ductal adenocarcinoma (pancreatic cancer) is notoriously bad. In a study published in this issue of Gut, Kim and colleagues1 make it clear that K-ras mutation in apparently benign pancreatic tissue at some distance from the tumour contributes to poor survival (see page 1598). This could indicate the presence of occult tumour cells in the resection margin but could also indicate that tumours developing in a large field of mutation carrying cells are more aggressive. This offers hope to patients where resection leaves behind no mutant cells in the margin but also suggests that the most aggressive tumours might prove to be the easiest to detect in asymptomatic patients.
A cynical reader might be forgiven for passing over the article by Kim and colleagues.1 The paper talks of an unfavourable prognosis for patients with pancreatic cancer—cynics will respond with the observation
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- Unfavourable prognosis associated with K-ras gene mutation in pancreatic cancer surgical margins
- J Kim, H A Reber, S M Dry, D Elashoff, S L Chen, N Umetani, M Kitago, O J Hines, K K Kazanjian, S Hiramatsu, A J Bilchik, S Yong, M Shoup, and D S B Hoon
Gut 2006 55: 1598-1605.[Abstract] [Full Text] [PDF]
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