Elevated perioperative serum CA 19‐9 levels are independent predictors of poor survival in patients with resectable cholangiocarcinoma. Issue 4 (2nd June 2014) - Kondo, Naru
Abstract Background and Objectives Identification of prognostic markers is important to establish a perioperative therapeutic strategy for resectable cholangiocarcinoma (CC). The aim of this study was to investigate whether perioperative serum carbohydrate antigen 19‐9 (CA19‐9) levels can predict survival of patients who underwent surgical resection for CC. Methods The study included 106 patients who underwent surgical resection for CC. Serum CA19‐9 levels were measured preoperatively after biliary drainage and postoperatively about 4 weeks after surgery. The association of clinicopathological factors (including perioperative serum CA19‐9 levels) with overall survival (OS) was analyzed with univariate and multivariate analyses. Results Differences in OS were significant between groups divided on the basis of two preoperative CA19‐9 cutoff values (in U/ml) of 37 and 200 and three postoperative CA19‐9 cutoff values (in U/ml) of 37, 100, and 200. In multivariate analysis, absence of postoperative adjuvant chemotherapy (P = 0.002), lymph node metastasis (P = 0.0002), preoperative CA19‐9 (≥200 IU/ml) (P = 0.03), and postoperative CA19‐9 (≥37 IU/ml) (P < 0.0001) were identified as independent predictors of poor OS. Conclusion Both pre‐ and postoperative serum CA19‐9 levels predict the survival of patients with resectable CC, and may contribute to the establishment of a new therapeutic strategy. J. Surg. Oncol. 2014; 110:422–429. © 2014 Wiley Periodicals, Inc.