THE ROLE OF FLOW CYTOMETRIC DNA ANALYSIS IN DETERMINING PROGNOSIS OF RESECTABLE DUCTAL ADENOCARCINOMA OF THE PANCREAS

Carcinoma of the pancreas is a leading cause of cancer mortality in th e United States. Improvement in prediction of survival is needed. Flow cytometric analysis as a prognostic tool has produced conflicting res ults. We retrospectively analyzed the clinicopathologic features, oper ative factors, and outcome of 39 curative resections for ductal adenoc arcinoma of the head of the pancreas performed at Indiana University M edical Center between 1989 and 1994. The group was composed of 20 fema les and 19 males. Procedures performed were Whipple without vagotomy ( n = 5), Whipple with vagotomy (n = 19), pylorus-preserving Whipple (n = 12) and total pancreatectomy (n = 3). Thirty-two tumors were suitabl e for DNA analysis. Of the 32 patients with flow cytometric data, 33 p er cent (3/9) of living patients and 39 per cent (9/23) of deceased pa tients had aneuploid tumors (P = 0.999). The average S-phase for livin g patients was 8.3 per cent +/- 3.8 per cent, and 16.1 per cent +/- 13 .6 per cent for deceased patients (P = 0.115). In the multivariate ana lysis, only lymphatic invasion (P = 0.015) and alkaline phosphatase le vel (P = 0.024) predicted poor survival. Our data show no correlation between flow cytometric DNA ploidy, S-phase analysis, and prognosis in patients undergoing curative resection for ductal adenocarcinoma of t he pancreatic head.