Preoperative CA 19‐9 kinetics as a prognostic variable in radiographically resectable pancreatic adenocarcinoma. Issue 3 (20th October 2014)

• Record Type: Journal Article
• Authors: Brown, Erin G.; Canter, Robert J.; Bold, Richard J.
• Is Part Of: Journal of surgical oncology. Volume 111:Issue 3(2015:Mar. 01)
• Page Start: 293
• Page End: 298
• Publication Date: 2014-10-20
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23812
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23812-sec-0001" sec-type="section"> <title>Background and Objectives</title> <p>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.</p> </sec> <sec id="jso23812-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="jso23812-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 0.04, <italic>P</italic> = 0.02); however, for patients with resectable disease, CA 19‐9 changes did not predict survival.</p> </sec> <sec id="jso23812-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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. <italic>J. Surg. Oncol. 2015 111:293–298</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>