Predictive and prognostic value of CA 19-9 in resected pancreatic adenocarcinoma

Joshua G. Barton, John P. Bois, Michael G. Sarr, Christina M. Wood, Rui Qin, Kristine M. Thomsen, Michael L. Kendrick, Michael B. Farnell

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background Preoperative serum values of CA 19-9 have been reported to be associated with survival in patients undergoing resection of pancreatic adenocarcinoma. Hypothesis Preoperative CA 19-9 levels are associated with margin and/or lymph node status in patients undergoing pancreatoduodenectomy for pancreatic carcinoma. Methods We conducted a review of 143 patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma from July 2001 through April 2006 at our institution. Preoperative serum values of CA 19-9 and total bilirubin, pathologic findings, and survival were analyzed. A cutoff value for CA 19-9 (120 U/ml) was determined using a Cox proportional hazards model for survival. Results Overall survival at 1, 3, and 5 years for patients with CA 19-9≤120 U/ml was 76%, 41%, and 31%, respectively, versus 64%, 17%, and 10% for patients with CA 19-9>120 U/ml (p=0.002). CA 19-9>120 U/ml was not associated, however, with a greater chance of an R1 or R2 resection (p=0.86), tumor involving the SMA margin (p=0.88), tumor at the portal vein groove (p=0.14), or lymph node metastases (p=0.89). Conclusions Our findings do not support a cutoff value for CA 19-9 that is associated with margin or lymph node involvement. Preoperative CA 19-9≤120 U/ml is, however, associated with increased overall and recurrence-free survival.

Original languageEnglish (US)
Pages (from-to)2050-2058
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume13
Issue number11
DOIs
StatePublished - 2009

Fingerprint

Adenocarcinoma
Survival
Pancreaticoduodenectomy
Lymph Nodes
Portal Vein
Serum
Bilirubin
Proportional Hazards Models
Neoplasms
Neoplasm Metastasis
Recurrence

Keywords

  • CA 19-9 antigen
  • Pancreatic carcinoma
  • Pancreatic ductal carcinoma
  • Predictive value of tests
  • Survival analysis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology
  • Medicine(all)

Cite this

Barton, J. G., Bois, J. P., Sarr, M. G., Wood, C. M., Qin, R., Thomsen, K. M., ... Farnell, M. B. (2009). Predictive and prognostic value of CA 19-9 in resected pancreatic adenocarcinoma. Journal of Gastrointestinal Surgery, 13(11), 2050-2058. https://doi.org/10.1007/s11605-009-0849-z

Predictive and prognostic value of CA 19-9 in resected pancreatic adenocarcinoma. / Barton, Joshua G.; Bois, John P.; Sarr, Michael G.; Wood, Christina M.; Qin, Rui; Thomsen, Kristine M.; Kendrick, Michael L.; Farnell, Michael B.

In: Journal of Gastrointestinal Surgery, Vol. 13, No. 11, 2009, p. 2050-2058.

Research output: Contribution to journalArticle

Barton, JG, Bois, JP, Sarr, MG, Wood, CM, Qin, R, Thomsen, KM, Kendrick, ML & Farnell, MB 2009, 'Predictive and prognostic value of CA 19-9 in resected pancreatic adenocarcinoma', Journal of Gastrointestinal Surgery, vol. 13, no. 11, pp. 2050-2058. https://doi.org/10.1007/s11605-009-0849-z
Barton, Joshua G. ; Bois, John P. ; Sarr, Michael G. ; Wood, Christina M. ; Qin, Rui ; Thomsen, Kristine M. ; Kendrick, Michael L. ; Farnell, Michael B. / Predictive and prognostic value of CA 19-9 in resected pancreatic adenocarcinoma. In: Journal of Gastrointestinal Surgery. 2009 ; Vol. 13, No. 11. pp. 2050-2058.
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abstract = "Background Preoperative serum values of CA 19-9 have been reported to be associated with survival in patients undergoing resection of pancreatic adenocarcinoma. Hypothesis Preoperative CA 19-9 levels are associated with margin and/or lymph node status in patients undergoing pancreatoduodenectomy for pancreatic carcinoma. Methods We conducted a review of 143 patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma from July 2001 through April 2006 at our institution. Preoperative serum values of CA 19-9 and total bilirubin, pathologic findings, and survival were analyzed. A cutoff value for CA 19-9 (120 U/ml) was determined using a Cox proportional hazards model for survival. Results Overall survival at 1, 3, and 5 years for patients with CA 19-9≤120 U/ml was 76{\%}, 41{\%}, and 31{\%}, respectively, versus 64{\%}, 17{\%}, and 10{\%} for patients with CA 19-9>120 U/ml (p=0.002). CA 19-9>120 U/ml was not associated, however, with a greater chance of an R1 or R2 resection (p=0.86), tumor involving the SMA margin (p=0.88), tumor at the portal vein groove (p=0.14), or lymph node metastases (p=0.89). Conclusions Our findings do not support a cutoff value for CA 19-9 that is associated with margin or lymph node involvement. Preoperative CA 19-9≤120 U/ml is, however, associated with increased overall and recurrence-free survival.",
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AU - Barton, Joshua G.

AU - Bois, John P.

AU - Sarr, Michael G.

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AU - Thomsen, Kristine M.

AU - Kendrick, Michael L.

AU - Farnell, Michael B.

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N2 - Background Preoperative serum values of CA 19-9 have been reported to be associated with survival in patients undergoing resection of pancreatic adenocarcinoma. Hypothesis Preoperative CA 19-9 levels are associated with margin and/or lymph node status in patients undergoing pancreatoduodenectomy for pancreatic carcinoma. Methods We conducted a review of 143 patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma from July 2001 through April 2006 at our institution. Preoperative serum values of CA 19-9 and total bilirubin, pathologic findings, and survival were analyzed. A cutoff value for CA 19-9 (120 U/ml) was determined using a Cox proportional hazards model for survival. Results Overall survival at 1, 3, and 5 years for patients with CA 19-9≤120 U/ml was 76%, 41%, and 31%, respectively, versus 64%, 17%, and 10% for patients with CA 19-9>120 U/ml (p=0.002). CA 19-9>120 U/ml was not associated, however, with a greater chance of an R1 or R2 resection (p=0.86), tumor involving the SMA margin (p=0.88), tumor at the portal vein groove (p=0.14), or lymph node metastases (p=0.89). Conclusions Our findings do not support a cutoff value for CA 19-9 that is associated with margin or lymph node involvement. Preoperative CA 19-9≤120 U/ml is, however, associated with increased overall and recurrence-free survival.

AB - Background Preoperative serum values of CA 19-9 have been reported to be associated with survival in patients undergoing resection of pancreatic adenocarcinoma. Hypothesis Preoperative CA 19-9 levels are associated with margin and/or lymph node status in patients undergoing pancreatoduodenectomy for pancreatic carcinoma. Methods We conducted a review of 143 patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma from July 2001 through April 2006 at our institution. Preoperative serum values of CA 19-9 and total bilirubin, pathologic findings, and survival were analyzed. A cutoff value for CA 19-9 (120 U/ml) was determined using a Cox proportional hazards model for survival. Results Overall survival at 1, 3, and 5 years for patients with CA 19-9≤120 U/ml was 76%, 41%, and 31%, respectively, versus 64%, 17%, and 10% for patients with CA 19-9>120 U/ml (p=0.002). CA 19-9>120 U/ml was not associated, however, with a greater chance of an R1 or R2 resection (p=0.86), tumor involving the SMA margin (p=0.88), tumor at the portal vein groove (p=0.14), or lymph node metastases (p=0.89). Conclusions Our findings do not support a cutoff value for CA 19-9 that is associated with margin or lymph node involvement. Preoperative CA 19-9≤120 U/ml is, however, associated with increased overall and recurrence-free survival.

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