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 journalReview article

62 Scopus citations

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 - Dec 1 2009

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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    Barton, J. G., Bois, J. P., Sarr, M. G., Wood, C. M., Qin, R., Thomsen, K. M., Kendrick, M. L., & 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