Prognostic Significance of Preoperative and Postoperative Ca 19–9 Normalization in Pancreatic Adenocarcinoma Treated With Neoadjuvant Therapy or Surgery First

Authors

Timothy P DiPeri
Timothy E Newhook
Laura R Prakash
Naruhiko Ikoma
Jessica E Maxwell
Michael P Kim
Jeffrey E Lee
Matthew H G Katz
Ching-Wei D Tzeng

Publication Date

11-1-2022

Journal

Journal of Surgical Oncology

Abstract

BACKGROUND: Normal(ization) of serum carbohydrate 19-9 (CA19-9) before/after surgery has not been compared in patients with pancreatic adenocarcinoma (PDAC) treated with neoadjuvant therapy (NT) versus surgery-first (SF).

METHODS: Characteristics for patients with PDAC who underwent resection from July 2011 to October 2018 were collected. Patients with pre-/postoperative CA19-9, bilirubin/dL, and initial CA19-9 > 1 U/ml were included. Overall survival (OS) and recurrence-free survival (RFS) were compared by pre-/postoperative CA19-9.

RESULTS: In patients receiving NT, normal pre/postoperative CA19-9 ("NT

CONCLUSIONS: While a normal(ized) postoperative CA19-9 may result in similar survival as preoperative normal(ization), postoperative normalization failed to occur in nearly 30% of SF patients. NT should be considered in patients presenting with elevated CA19-9. If considering SF, ideal patients may include those with normal CA19-9 at presentation.

Keywords

Adenocarcinoma, Bilirubin, CA-19-9 Antigen, Carbohydrates, Carcinoma, Pancreatic Ductal, Humans, Neoadjuvant Therapy, Pancreatic Neoplasms, Prognosis, Retrospective Studies, carbohydrate antigen 19-9, pancreas, oncology, cancer, biomarker

Comments

Data Availability Statement

PMID: 35726394