Post-adjuvant chemotherapy CA19-9 levels predict prognosis in patients with pancreatic ductal adenocarcinoma: A retrospective cohort study.

Abstract

BACKGROUND:

Carbohydrate antigen 19-9 (CA19-9) is a widely used tumor marker for pancreatic ductal adenocarcinoma (PDAC). In addition, several studies have reported the utility of both pre- and postoperative CA19-9 levels as prognostic factors in resectable PDAC. However, little is known about the implications of post-adjuvant chemotherapy (AC) CA19-9 levels. The purpose of this study was to examine the utility of the post-AC CA19-9 level as a prognostic marker for relapse-free survival (RFS) in resectable PDAC.

METHODS:

A total of 119 patients who completed AC were analyzed (normal post-AC CA19-9, n = 79; high post-AC CA19-9, n = 40). The upper limit of the normal (ULN) serum level of CA19-9 was 37 U/mL.

RESULTS:

Median RFS was significantly shorter for patients with high post-AC CA19-9 levels than for those with normal post-AC CA19-9 (10.4 months vs. 29.6 months, respectively; p < 0.001). After adjustment, high post-AC CA19-9 level was an independent predictive factor for short RFS (hazard ratio for RFS, 2.72). Median overall survival was significantly shorter in patients with high post-AC CA19-9 levels than in those with normal postoperative CA19-9 levels (24.7 months vs. 92.1 months, respectively; p < 0.001). The optimal cutoff value of post-AC CA19-9 levels for prediction of early recurrence was >1.5 × UNL (55.5 U/mL), with a 74.2% positive predictive value.

CONCLUSIONS:

The present results show that high post-AC CA19-9 level is an independent prognostic factor for short RFS in patients with resected PDAC. In addition, it may be useful for predicting early recurrence.

• Authors: Hiroshi Imaoka, Yasuhiro Shimizu, Yoshiki Senda, Seiji Natsume, Nobumasa Mizuno, Kazuo Hara, Susumu Hijioka, Nobuhiro Hieda, Masahiro Tajika, Tsutomu Tanaka, Makoto Ishihara, Yasumasa Niwa, Kenji Yamao
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) 2016 Jul-Aug Vol. 16 Issue 4 Pg. 658-64 ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 27178104 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Chemical References

• CA-19-9 Antigen

Topics

• Aged
• CA-19-9 Antigen (analysis)
• Carcinoma, Pancreatic Ductal (drug therapy, surgery)
• Chemotherapy, Adjuvant (methods)
• Cohort Studies
• Combined Modality Therapy
• Disease-Free Survival
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Pancreatic Neoplasms (drug therapy, surgery)
• Predictive Value of Tests
• Prognosis
• Retrospective Studies
• Survival Analysis