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.
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.
Authors: Dong S; Wang L; Guo Y B; Ying H F; Shen X H; Meng Z Q; Chen Hao; Chen Q W; Li Z S Journal: World J Surg Oncol Date: 2017-07-03 Impact factor: 2.754
Authors: Roman O Kowalchuk; Scott C Lester; Rondell P Graham; William S Harmsen; Lizhi Zhang; Thorvardur R Halfdanarson; Rory L Smoot; Hunter C Gits; Wen Wee Ma; Dawn Owen; Amit Mahipal; Robert C Miller; Michelle A Neben Wittich; Sean P Cleary; Robert R McWilliams; Michael G Haddock; Christopher L Hallemeier; Mark J Truty; Kenneth W Merrell Journal: Front Oncol Date: 2021-05-11 Impact factor: 6.244