Amika Moro1, Rittal Mehta1, Kota Sahara1,2, Diamantis I Tsilimigras1, Anghela Z Paredes1, Ayesha Farooq1, J Madison Hyer1, Itaru Endo2, Feng Shen3, Alfredo Guglielmi4, Luca Aldrighetti5, Matthew Weiss6, Todd W Bauer7, Sorin Alexandrescu8, George A Poultsides9, Shishir K Maithel10, Hugo P Marques11, Guillaume Martel12, Carlo Pulitano13, Olivier Soubrane14, Bas G Koerkamp15, Kazunari Sasaki16, Timothy M Pawlik17. 1. Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. 2. Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan. 3. Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China. 4. Department of Surgery, University of Verona, Verona, Italy. 5. Department of Surgery, Ospedale San Raffaele, Milan, Italy. 6. Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA. 7. Department of Surgery, University of Virginia, Charlottesville, VA, USA. 8. Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania. 9. Department of Surgery, Stanford University, Stanford, CA, USA. 10. Department of Surgery, Emory University, Atlanta, GA, USA. 11. Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal. 12. Department of Surgery, University of Ottawa, Ottawa, Canada. 13. Department of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia. 14. Department of Hepatobiliopancreatic Surgery and Liver Transplantation, AP-HP, Beaujon Hospital, Clichy, France. 15. Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. 16. Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA. 17. Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. tim.pawlik@osumc.edu.
Abstract
BACKGROUND: The objective of the current study was to assess the impact of serum CA19-9 and CEA and their combination on survival among patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC). METHODS: Patients who underwent curative-intent resection of ICC between 1990 and 2016 were identified using a multi-institutional database. Patients were categorized into four groups based on combinations of serum CA19-9 and CEA (low vs. high). Factors associated with 1-year mortality after hepatectomy were examined. RESULTS: Among 588 patients, 5-year OS was considerably better among patients with low CA19-9/low CEA (54.5%) compared with low CA19-9/high CEA (14.6%), high CA19-9/low CEA (10.0%), or high CA19-9/high CEA (0%) (P < 0.001). No difference in 1-year OS existed between patients who had either high CA19-9 (high CA19-9/low CEA: 70.4%) or high CEA levels (low CA19-9/high CEA: 72.5%) (P = 0.92). Although patients with the most favorable tumor marker profile (low CA19-9/low CEA) had the best 1-year survival (87.9%), 15.1% (n = 39) still died within a year of surgery. Among patients with low CA19-9/low CEA, a high neutrophil-to-lymphocyte ratio (NLR) (odds ratio 1.09; 95% confidence interval 1.03-1.64) and large size tumor (odds ratio 3.34; 95% confidence interval 1.40-8.10) were associated with 1-year mortality (P < 0.05). CONCLUSIONS: Patients with either a high CA19-9 and/or high CEA had poor 1-year survival. High NLR and large tumor size were associated with a greater risk of 1-year mortality among patients with favorable tumor marker profile.
BACKGROUND: The objective of the current study was to assess the impact of serum CA19-9 and CEA and their combination on survival among patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC). METHODS:Patients who underwent curative-intent resection of ICC between 1990 and 2016 were identified using a multi-institutional database. Patients were categorized into four groups based on combinations of serum CA19-9 and CEA (low vs. high). Factors associated with 1-year mortality after hepatectomy were examined. RESULTS: Among 588 patients, 5-year OS was considerably better among patients with low CA19-9/low CEA (54.5%) compared with low CA19-9/high CEA (14.6%), high CA19-9/low CEA (10.0%), or high CA19-9/high CEA (0%) (P < 0.001). No difference in 1-year OS existed between patients who had either high CA19-9 (high CA19-9/low CEA: 70.4%) or high CEA levels (low CA19-9/high CEA: 72.5%) (P = 0.92). Although patients with the most favorable tumor marker profile (low CA19-9/low CEA) had the best 1-year survival (87.9%), 15.1% (n = 39) still died within a year of surgery. Among patients with low CA19-9/low CEA, a high neutrophil-to-lymphocyte ratio (NLR) (odds ratio 1.09; 95% confidence interval 1.03-1.64) and large size tumor (odds ratio 3.34; 95% confidence interval 1.40-8.10) were associated with 1-year mortality (P < 0.05). CONCLUSIONS:Patients with either a high CA19-9 and/or high CEA had poor 1-year survival. High NLR and large tumor size were associated with a greater risk of 1-year mortality among patients with favorable tumor marker profile.
Authors: Kazunari Sasaki; Georgios A Margonis; Nikolaos Andreatos; Qinyu Chen; Carlotta Barbon; Fabio Bagante; Matthew Weiss; Irinel Popescu; Hugo P Marques; Luca Aldrighetti; Shishir K Maithel; Carlo Pulitano; Todd W Bauer; Feng Shen; George A Poultsides; Olivier Soubrane; Guillaume Martel; Bas Groot Koerkamp; Alfredo Guglielmi; Itaru Endo; Federico N Aucejo; Timothy M Pawlik Journal: HPB (Oxford) Date: 2018-06-08 Impact factor: 3.647
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Authors: Kelly J Lafaro; David Cosgrove; Jean-Francois H Geschwind; Ihab Kamel; Joseph M Herman; Timothy M Pawlik Journal: Gastroenterol Res Pract Date: 2015-05-19 Impact factor: 2.260
Authors: Sandra Pavicevic; Sophie Reichelt; Deniz Uluk; Isabella Lurje; Cornelius Engelmann; Dominik P Modest; Uwe Pelzer; Felix Krenzien; Nathanael Raschzok; Christian Benzing; Igor M Sauer; Sebastian Stintzing; Frank Tacke; Wenzel Schöning; Moritz Schmelzle; Johann Pratschke; Georg Lurje Journal: Cancers (Basel) Date: 2022-02-17 Impact factor: 6.639