chapter  8
10 Pages

Tumor Morphological Behavior and Treatment Outcome

WithJohn Lowengrub

Differences in the biophysical properties between individual tumors likely contribute to the variable outcomes of patients. The mathematical theory of tumor growth could be scaled up from the microscopic level to the macroscopic tissue level by considering the stroma as a global relaxation mechanism that strongly influenced gross tumor morphology. The mathematical simulations suggest that tumor morphology could provide significant insight into the behavior of pancreatic cancer. The assessment of stroma through pathological scoring from surgically resected specimens would not give the information that clinicians need at the time of initial diagnosis, and could not be applied to the 80"-85" of patients with PDAC who present with locally advanced or metastatic disease at diagnosis. It is clear that the stroma plays a complex role in PDAC, but there is consensus that clarifying how the stroma influences the cancer cells of PDAC before and during therapy will have important clinical implications that may directly impact patient survival outcomes.