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Cancers 2019, 11(4), 497;

Head and Body/Tail Pancreatic Carcinomas Are Not the Same Tumors

Laboratoire Oncologie Prédictive, Centre de Recherche en Cancérologie de Marseille, INSERM UMR1068, CNRS UMR725, Aix-Marseille Université, 13273 Marseille, France
Faculté de Médecine, Aix-Marseille Université, 13385 Marseille, France
Département de Chirurgie Générale et Viscérale, AP-HM, 13015 Marseille, France
Département d’Oncologie Médicale, Institut Paoli-Calmettes, 13009 Marseille, France
Author to whom correspondence should be addressed.
Received: 7 February 2019 / Revised: 13 March 2019 / Accepted: 13 March 2019 / Published: 8 April 2019
(This article belongs to the Special Issue Advances in Pancreatic Cancer Research)
PDF [591 KB, uploaded 8 April 2019]


The association between pancreatic ductal adenocarcinoma (PDAC) location (head vs. Body/Tail (B/T)) and clinical outcome remains controversial. We collected clinicopathological and gene expression data from 249 resected PDAC samples from public data sets, and we compared data between 208 head and 41 B/T samples. The 2-year overall survival (OS) was better for the head than for the B/T PDACs (44 vs. 27%, p = 0.043), especially when comparing tumors with similar TNM classification (T3/4N0M0: 67% vs. 17%, p = 0.002) or from the same molecular class (squamous subtype: 31% vs. 0%, p < 0.0001). Bailey’s molecular subtypes were differentially distributed within the two groups, with the immunogenic subtype being underrepresented in the “B/T” group (p = 0.005). Uni- and multivariate analyses indicated that PDAC anatomic location was an independent prognostic factor. Finally, the supervised analysis identified 334 genes differentially expressed. Genes upregulated in the “head” group suggested lymphocyte activation and pancreas exocrine functions. Genes upregulated in the “B/T” group were related to keratinocyte differentiation, in line with the enrichment for squamous phenotype. We identified a robust gene expression signature (GES) associated with B/T PDAC location, suggesting that head and B/T PDAC are different. This GES could serve as an indicator for differential therapeutic management based on PDAC location.
Keywords: pancreatic cancer; tumor location; expression profiling; prognosis; survival pancreatic cancer; tumor location; expression profiling; prognosis; survival
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Birnbaum, D.J.; Bertucci, F.; Finetti, P.; Birnbaum, D.; Mamessier, E. Head and Body/Tail Pancreatic Carcinomas Are Not the Same Tumors. Cancers 2019, 11, 497.

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