OBJECTIVES: Given the increased detection of occult pancreatic neoplasms with modern imaging modalities, it is often difficult to determine the risk of malignancy before curative pancreatectomy. We reviewed patients who underwent pancreatectomy to determine factors predictive of malignancy with particular attention to the serum marker carbohydrate antigen 19-9 (CA19-9). METHODS: One hundred eighteen patients underwent radical pancreatectomy for malignant (n = 59) or benign (n = 59) pancreatic lesions. Demographic data, preoperative CA19-9 levels (normal, <37 U/mL), and follow-up were obtained from patient charts. Logistic regression analysis was used to determine univariate and multivariate predictors of malignancy. RESULTS: Significant multivariate predictors of malignancy were increased CA19-9, age older than 50 years, and preoperative jaundice. The sensitivity and specificity of increased preoperative CA19-9 alone were 71% and 83%, respectively. The combination of age older than 50 years and jaundice was a more accurate predictor than CA19-9 (sensitivity, 76%; specificity, 92%). Increased CA19-9 was highly specific (97%) for malignancy in older jaundiced patients or when the preoperative level was greater than 150 U/mL. CONCLUSIONS: Age and preoperative jaundice are more predictive of malignancy than CA19-9 alone unless levels are greater than 150 U/mL. Preoperative CA19-9 levels should be interpreted within the context of these other clinical factors.
OBJECTIVES: Given the increased detection of occult pancreatic neoplasms with modern imaging modalities, it is often difficult to determine the risk of malignancy before curative pancreatectomy. We reviewed patients who underwent pancreatectomy to determine factors predictive of malignancy with particular attention to the serum marker carbohydrate antigen 19-9 (CA19-9). METHODS: One hundred eighteen patients underwent radical pancreatectomy for malignant (n = 59) or benign (n = 59) pancreatic lesions. Demographic data, preoperative CA19-9 levels (normal, <37 U/mL), and follow-up were obtained from patient charts. Logistic regression analysis was used to determine univariate and multivariate predictors of malignancy. RESULTS: Significant multivariate predictors of malignancy were increased CA19-9, age older than 50 years, and preoperative jaundice. The sensitivity and specificity of increased preoperative CA19-9 alone were 71% and 83%, respectively. The combination of age older than 50 years and jaundice was a more accurate predictor than CA19-9 (sensitivity, 76%; specificity, 92%). Increased CA19-9 was highly specific (97%) for malignancy in older jaundicedpatients or when the preoperative level was greater than 150 U/mL. CONCLUSIONS: Age and preoperative jaundice are more predictive of malignancy than CA19-9 alone unless levels are greater than 150 U/mL. Preoperative CA19-9 levels should be interpreted within the context of these other clinical factors.
Authors: Sherif R Z Abdel-Misih; Ioannis Hatzaras; Carl Schmidt; Tanios-Bekaii Saab; Dori Klemanski; Peter Muscarella; W Scott Melvin; E Christopher Ellison; Mark Bloomston Journal: Ann Surg Oncol Date: 2010-11-02 Impact factor: 5.344
Authors: Ioannis Hatzaras; Carl Schmidt; Peter Muscarella; W Scott Melvin; E Christopher Ellison; Mark Bloomston Journal: HPB (Oxford) Date: 2010-03 Impact factor: 3.647
Authors: Katherine E Poruk; D Z Gay; K Brown; J D Mulvihill; K M Boucher; C L Scaife; M A Firpo; S J Mulvihill Journal: Curr Mol Med Date: 2013-03 Impact factor: 2.222
Authors: Jonathan M Hernandez; Sarah M Cowgill; Sam Al-Saadi; Amy Collins; Sharona B Ross; Jennifer Cooper; Desireé Villadolid; Emmanuel Zervos; Alexander Rosemurgy Journal: J Gastrointest Surg Date: 2008-10-30 Impact factor: 3.452
Authors: Sylvester N Osayi; Mark Bloomston; Carl M Schmidt; E Christopher Ellison; Peter Muscarella Journal: Biomed Res Int Date: 2014-06-24 Impact factor: 3.411