BACKGROUND: Pancreatic cancer is one of the most deadly cancers, and serum carbohydrate antigen 19-9 (CA19-9) level has been reported to be a useful prognostic marker in pancreatic cancer. The purpose of this study was to determine which prognostic factor (preoperative or postoperative serum CA19-9 level) is more useful. METHODS: Pre- and postoperative serum CA19-9 levels were measured in 109 patients who underwent surgical resection for pancreatic cancer between 1998 and 2009, and their relationships to clinicopathological factors and overall survival were analyzed with univariate and multivariate methods. RESULTS: In univariate analysis, tumor location (P = 0.019), postoperative adjuvant chemotherapy (P < 0.001), residual tumor factor status (P < 0.001), UICC pT stage (P = 0.004), lymph node metastasis (P = 0.015), and UICC final stage (P = 0.015) were significantly associated with overall survival. Differences in overall survival were significant between groups divided on the basis of four postoperative CA19-9 cutoff values (37, 100, 200, and 500 U/ml) but not significant between groups divided on the basis of the same four preoperative CA19-9 cutoff values. Pre- to postoperative increase in CA19-9 level also was significantly associated with poor prognosis. In multivariate analysis, postoperative adjuvant chemotherapy (hazard ratio, 1.59; P = 0.004) and postoperative CA19-9 cutoff value of 37 U/ml (HR, 1.64; P = 0.004) remained independent predictors of prognosis. CONCLUSIONS: Postoperative CA19-9 level is a better prognostic factor than preoperative CA19-9 level, and curative surgery for resectable pancreatic cancer should be tried regardless of the preoperative CA19-9 level.
BACKGROUND:Pancreatic cancer is one of the most deadly cancers, and serum carbohydrate antigen 19-9 (CA19-9) level has been reported to be a useful prognostic marker in pancreatic cancer. The purpose of this study was to determine which prognostic factor (preoperative or postoperative serum CA19-9 level) is more useful. METHODS: Pre- and postoperative serum CA19-9 levels were measured in 109 patients who underwent surgical resection for pancreatic cancer between 1998 and 2009, and their relationships to clinicopathological factors and overall survival were analyzed with univariate and multivariate methods. RESULTS: In univariate analysis, tumor location (P = 0.019), postoperative adjuvant chemotherapy (P < 0.001), residual tumor factor status (P < 0.001), UICC pT stage (P = 0.004), lymph node metastasis (P = 0.015), and UICC final stage (P = 0.015) were significantly associated with overall survival. Differences in overall survival were significant between groups divided on the basis of four postoperative CA19-9 cutoff values (37, 100, 200, and 500 U/ml) but not significant between groups divided on the basis of the same four preoperative CA19-9 cutoff values. Pre- to postoperative increase in CA19-9 level also was significantly associated with poor prognosis. In multivariate analysis, postoperative adjuvant chemotherapy (hazard ratio, 1.59; P = 0.004) and postoperative CA19-9 cutoff value of 37 U/ml (HR, 1.64; P = 0.004) remained independent predictors of prognosis. CONCLUSIONS: Postoperative CA19-9 level is a better prognostic factor than preoperative CA19-9 level, and curative surgery for resectable pancreatic cancer should be tried regardless of the preoperative CA19-9 level.
Authors: Margaret A Tempero; J Pablo Arnoletti; Stephen Behrman; Edgar Ben-Josef; Al B Benson; Jordan D Berlin; John L Cameron; Ephraim S Casper; Steven J Cohen; Michelle Duff; Joshua D I Ellenhorn; William G Hawkins; John P Hoffman; Boris W Kuvshinoff; Mokenge P Malafa; Peter Muscarella; Eric K Nakakura; Aaron R Sasson; Sarah P Thayer; Douglas S Tyler; Robert S Warren; Samuel Whiting; Christopher Willett; Robert A Wolff Journal: J Natl Compr Canc Netw Date: 2010-09 Impact factor: 11.908
Authors: John R Bergquist; Tommy Ivanics; Curtis B Storlie; Ryan T Groeschl; May C Tee; Elizabeth B Habermann; Rory L Smoot; Michael L Kendrick; Michael B Farnell; Lewis R Roberts; Gregory J Gores; David M Nagorney; Mark J Truty Journal: J Surg Oncol Date: 2016-07-20 Impact factor: 3.454
Authors: Steve Walston; Joseph Salloum; Carmine Grieco; Evan Wuthrick; Dayssy A Diaz; Christian Barney; Andrei Manilchuk; Carl Schmidt; Mary Dillhoff; Timothy M Pawlik; Terence M Williams Journal: Am J Clin Oncol Date: 2018-12 Impact factor: 2.339
Authors: Sinziana Dumitra; Mohammad H Jamal; Jad Aboukhalil; Suhail A Doi; Prosanto Chaudhury; Mazen Hassanain; Peter P Metrakos; Jeffrey S Barkun Journal: HPB (Oxford) Date: 2013-03-22 Impact factor: 3.647