Abstract
Background and Objectives: Serial levels of CA 19-9 are correlated with treatment response and survival; however, little is known about CA 19-9 kinetics in the absence of therapy. We hypothesize that preoperative CA 19-9 kinetics predict rate of resectability as well as survival. Methods: Retrospective review of 72 patients with radiographically resectable pancreatic adenocarcinoma with two pre-operative CA 19-9 levels prior to planned pancreaticoduodenectomy. Primary outcome measures were resectability and overall survival. Results: Forty-seven out of 72 patients (65%) had resectable disease. Unresectable patients had higher absolute change in CA 19-9 than patients with resectable disease (97 U/ml vs. 34 U/ml) as well as higher rate of change (4 U/ml/day vs. 1 U/ml/day). Receiver operating characteristic curves identified predictive thresholds for absolute (≥50 U/ml) and rate of CA 19-9 change (≥1 U/ml/day) that accurately identified unresectable patients. Survival analysis revealed that a change in CA 19-9 <50 U/ml and a rate of change <1 U/ml/day predicted improved survival (P=0.04, P=0.02); however, for patients with resectable disease, CA 19-9 changes did not predict survival. Conclusions: Preoperative kinetics of CA 19-9 predict resectable disease for pancreatic cancer. These variables also predict overall survival; however, these do not predict survival for those with resectable disease.
Original language | English (US) |
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Pages (from-to) | 293-298 |
Number of pages | 6 |
Journal | Journal of Surgical Oncology |
Volume | 111 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2015 |
Keywords
- CA19-9
- Pancreas cancer
- Tumor marker
ASJC Scopus subject areas
- Surgery
- Oncology