PURPOSE: We assessed the possibility of predicting the time of onset of liver metastases by measuring the postoperative changes in serum carbohydrate antigen (CA)19-9 after curative resection of pancreatic cancers. METHODS: Among 28 patients who underwent histologically defined curative resection of pancreatic cancer between 1984 and 1999, liver metastasis developed in 11 patients with elevated serum CA19-9 levels. We plotted the serum CA19-9 levels against time on a semilogarithmic graph. Over the linear part of the curve, the time when log[CA19-9] equaled zero was defined as the time of onset of liver metastases. The log[CA19-9] level doubling time was then calculated and evaluated in relation to the survival period. RESULTS: The serum CA19-9 levels increased linearly in 10 of the 11 patients. The predicted time of onset of liver metastasis ranged from preoperative day 163.0 to postoperative day 27.1, being preoperative in eight patients. The doubling time until death correlated strongly with survival in the eight patients with maintained log[CA19-9] linearity. CONCLUSION: The onset of liver metastases might be preoperative in patients with advanced pancreatic cancer. Therefore, neoadjuvant chemotherapy should be mandatory even if there is no sign of liver metastases.
PURPOSE: We assessed the possibility of predicting the time of onset of liver metastases by measuring the postoperative changes in serum carbohydrate antigen (CA)19-9 after curative resection of pancreatic cancers. METHODS: Among 28 patients who underwent histologically defined curative resection of pancreatic cancer between 1984 and 1999, liver metastasis developed in 11 patients with elevated serum CA19-9 levels. We plotted the serum CA19-9 levels against time on a semilogarithmic graph. Over the linear part of the curve, the time when log[CA19-9] equaled zero was defined as the time of onset of liver metastases. The log[CA19-9] level doubling time was then calculated and evaluated in relation to the survival period. RESULTS: The serum CA19-9 levels increased linearly in 10 of the 11 patients. The predicted time of onset of liver metastasis ranged from preoperative day 163.0 to postoperative day 27.1, being preoperative in eight patients. The doubling time until death correlated strongly with survival in the eight patients with maintained log[CA19-9] linearity. CONCLUSION: The onset of liver metastases might be preoperative in patients with advanced pancreatic cancer. Therefore, neoadjuvant chemotherapy should be mandatory even if there is no sign of liver metastases.
Authors: R A Abrams; L B Grochow; A Chakravarthy; T A Sohn; M L Zahurak; T L Haulk; S Ord; R H Hruban; K D Lillemoe; H A Pitt; J L Cameron; C J Yeo Journal: Int J Radiat Oncol Biol Phys Date: 1999-07-15 Impact factor: 7.038
Authors: R C Montgomery; J P Hoffma; E A Ross; L B Riley; J A Ridge; B L Eisenberg Journal: J Gastrointest Surg Date: 1998 Jan-Feb Impact factor: 3.452
Authors: T Yoshimasu; S Maebeya; T Suzuma; T Bessho; H Tanino; J Arimoto; T Sakurai; Y Naito Journal: Int J Biol Markers Date: 1999 Apr-Jun Impact factor: 3.248
Authors: M Rapellino; P Piantino; F Pecchio; E Ruffini; A Cavallo; E Scappaticci; S Baldi; E Ciocia; S Pivetti Journal: Int J Biol Markers Date: 1994 Impact factor: 3.248
Authors: Masakazu Hashimoto; John David Konda; Stephanie Perrino; Maria Celia Fernandez; Andrew M Lowy; Pnina Brodt Journal: Mol Cancer Ther Date: 2021-09-22 Impact factor: 6.009