Elevated baseline CA19-9 levels correlate with adverse prognosis in patients with early- or advanced-stage pancreas cancer

Ludmila Katherine Martin, Lai Wei, Elizabeth Trolli, Tanios Bekaii-Saab

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

CA19-9 is the most specific biomarker for pancreas cancer. We investigated the prognostic significance of normal (≤37 U/mL) versus elevated (>37 U/mL) CA19-9 levels in patients with resected and advanced pancreas cancer. Relevant data were obtained from patients treated for early-stage or advanced pancreatic adenocarcinoma at our institution. Log-rank tests were used to evaluate relationship between CA19-9 and clinical outcomes of interest for both early- and advanced-stage patients. A total of 123 patients were included (Group A: N = 30 stage I/II; Group B: N = 93 stage III/IV). In group A, elevated preoperative CA19-9 was significantly associated with lymph node involvement (p = 0.031), tumor ≥3 cm (p = 0.011), and lack of tumor differentiation (p = 0.048). Failure of postoperative CA19-9 to normalize predicted significantly worse DFS (p = 0.021). For group B, elevated baseline CA19-9 was associated with shorter OS on chemotherapy (p = 0.0008) and decline in CA19-9 >25 % with treatment was a significant predictor of improved OS (p = 0.0099). Higher than normal CA19-9 level is an adverse prognostic factor in both early and advanced settings and may prove to be useful in the selection of patients for more aggressive therapy in future trials. CA19-9 level decrease of >25 % predicts improved survival in advanced disease on chemotherapy.

Original languageEnglish (US)
Pages (from-to)3101-3107
Number of pages7
JournalMedical Oncology
Volume29
Issue number5
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

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Pancreatic Neoplasms
Drug Therapy
Patient Selection
Neoplasms
Adenocarcinoma
Biomarkers
Lymph Nodes
Survival
Therapeutics

Keywords

  • Biomarker
  • CA19-9
  • Pancreas cancer
  • Prognostic

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Elevated baseline CA19-9 levels correlate with adverse prognosis in patients with early- or advanced-stage pancreas cancer. / Martin, Ludmila Katherine; Wei, Lai; Trolli, Elizabeth; Bekaii-Saab, Tanios.

In: Medical Oncology, Vol. 29, No. 5, 01.12.2012, p. 3101-3107.

Research output: Contribution to journalArticle

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abstract = "CA19-9 is the most specific biomarker for pancreas cancer. We investigated the prognostic significance of normal (≤37 U/mL) versus elevated (>37 U/mL) CA19-9 levels in patients with resected and advanced pancreas cancer. Relevant data were obtained from patients treated for early-stage or advanced pancreatic adenocarcinoma at our institution. Log-rank tests were used to evaluate relationship between CA19-9 and clinical outcomes of interest for both early- and advanced-stage patients. A total of 123 patients were included (Group A: N = 30 stage I/II; Group B: N = 93 stage III/IV). In group A, elevated preoperative CA19-9 was significantly associated with lymph node involvement (p = 0.031), tumor ≥3 cm (p = 0.011), and lack of tumor differentiation (p = 0.048). Failure of postoperative CA19-9 to normalize predicted significantly worse DFS (p = 0.021). For group B, elevated baseline CA19-9 was associated with shorter OS on chemotherapy (p = 0.0008) and decline in CA19-9 >25 {\%} with treatment was a significant predictor of improved OS (p = 0.0099). Higher than normal CA19-9 level is an adverse prognostic factor in both early and advanced settings and may prove to be useful in the selection of patients for more aggressive therapy in future trials. CA19-9 level decrease of >25 {\%} predicts improved survival in advanced disease on chemotherapy.",
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