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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Shorter Treatment-Naïve Leukocyte Telomere Length is Associated with Poorer Overall Survival of Patients with Pancreatic Ductal Adenocarcinoma

Samuel O. Antwi, William R. Bamlet, Richard M. Cawthon, Kari G. Rabe, Brooke R. Druliner, Hugues Sicotte, Aminah Jatoi, Amit Mahipal, Lisa A. Boardman, Ann L. Oberg and Gloria M. Petersen
Samuel O. Antwi
1Division of Epidemiology, Mayo Clinic, Jacksonville, Florida.
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  • For correspondence: Antwi.samuel@mayo.edu
William R. Bamlet
2Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
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  • ORCID record for William R. Bamlet
Richard M. Cawthon
3Department of Human Genetics, University of Utah, Salt Lake City, Utah.
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Kari G. Rabe
2Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
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Brooke R. Druliner
4Gastroenterology Laboratory, Mayo Clinic, Rochester, Minnesota.
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Hugues Sicotte
2Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
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Aminah Jatoi
5Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota.
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Amit Mahipal
5Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota.
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Lisa A. Boardman
6Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
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Ann L. Oberg
2Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
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Gloria M. Petersen
7Division of Epidemiology, Mayo Clinic, Rochester, Minnesota.
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DOI: 10.1158/1055-9965.EPI-20-1279 Published January 2021
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Abstract

Background: Critically shortened telomeres contribute to chromosomal instability and neoplastic transformation and are associated with early death of patients with certain cancer types. Shorter leukocyte telomere length (LTL) has been associated with higher risk for pancreatic ductal adenocarcinoma (PDAC) and might be associated also with survival of patients with PDAC. We investigated the association between treatment-naïve LTL and overall survival of patients with incident PDAC.

Methods: The study included 642 consecutively enrolled PDAC patients in the Mayo Clinic Biospecimen Resource for Pancreas Research. Blood samples were obtained at the time of diagnosis, before the start of cancer treatment, from which LTL was assayed by qRT-PCR. LTL was first modeled as a continuous variable (per-interquartile range decrease in LTL) and then as a categorized variable (short, medium, long). Multivariable-adjusted HRs and 95% confidence intervals (CI) were calculated for overall mortality using Cox proportional hazard models.

Results: Shorter treatment-naïve LTL was associated with higher mortality among patients with PDAC (HRcontinuous = 1.13, 95% CI: 1.01–1.28, P = 0.03; HRshortest vs. longest LTL = 1.29, 95% CI: 1.05–1.59, Ptrend = 0.01). There was a difference in the association between LTL and overall mortality by tumor stage at diagnosis; resectable tumors (HRcontinuous = 0.91; 95% CI: 0.73–1.12), locally advanced tumors (HRcontinuous = 1.29; 95% CI: 1.07–1.56), and metastatic tumors (HRcontinuous = 1.17; 95% CI: 0.96–1.42), Pinteraction = 0.04.

Conclusion: Shorter treatment-naïve LTL is associated with poorer overall survival of patients with incident PDAC.

Impact: Peripheral blood LTL might be a prognostic marker for PDAC.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2021;30:210–6

  • Received August 31, 2020.
  • Revision received October 14, 2020.
  • Accepted November 2, 2020.
  • Published first November 13, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 30 (1)
January 2021
Volume 30, Issue 1
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Shorter Treatment-Naïve Leukocyte Telomere Length is Associated with Poorer Overall Survival of Patients with Pancreatic Ductal Adenocarcinoma
Samuel O. Antwi, William R. Bamlet, Richard M. Cawthon, Kari G. Rabe, Brooke R. Druliner, Hugues Sicotte, Aminah Jatoi, Amit Mahipal, Lisa A. Boardman, Ann L. Oberg and Gloria M. Petersen
Cancer Epidemiol Biomarkers Prev January 1 2021 (30) (1) 210-216; DOI: 10.1158/1055-9965.EPI-20-1279

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Shorter Treatment-Naïve Leukocyte Telomere Length is Associated with Poorer Overall Survival of Patients with Pancreatic Ductal Adenocarcinoma
Samuel O. Antwi, William R. Bamlet, Richard M. Cawthon, Kari G. Rabe, Brooke R. Druliner, Hugues Sicotte, Aminah Jatoi, Amit Mahipal, Lisa A. Boardman, Ann L. Oberg and Gloria M. Petersen
Cancer Epidemiol Biomarkers Prev January 1 2021 (30) (1) 210-216; DOI: 10.1158/1055-9965.EPI-20-1279
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