Clinical value and impact on prognosis of peri-operative CA 19-9 serum levels in stage I and II adenocarcinoma of the pancreas

Abstract

CA 19-9 is a marker correlated to the clinical evolution of pancreatic adenocarcinoma. To analyze the clinical value of pre- and postoperative CA 19-9 serum levels in stage I and II pancreatic cancer. We analyzed 61 patients resected for pancreatic cancer. Patients were evaluated about the pre-operative CA 19-9 values and then divided into 3 groups: high, high-low and low, on the basis of pre- and postoperative CA 19-9 levels. The correlations between these groups and age, sex, pT, pN, tumor stage, jaundice, surgical radicality, tumor size, number of harvested and positive lymph nodes, grading, overall and major morbidities and post-operative mortality together with survival rates were analyzed. Higher values of pre-operative CA 19-9 were significantly correlated to the presence of jaundice, high pT, pN, stage and higher number of metastatic lymph nodes. In 49 patients (80.3 %) an R0 resection was performed. Five-year overall survival (OS) and disease free survival (DFS) were significantly better in patients with high levels of pre-operative CA 19-9, even in R0 cases. After stratification, 30 patients were included in the high group, 13 in the high-low group and 18 in the low group. A statistically significant correlation was found between the CA 19-9 groups and the lymph nodal positivity, not between CA 19-9 and pT. OS and DFS were significantly better in low group patients. We confirm the prognostic value of preoperative CA 19-9 serum levels. We do not support early postoperative modifications of CA19-9 as an adjunctive prognostic variable.

Stiehopus japonieus acidic mucopolysaccharide inhibits the proliferation of pancreatic cancer SW1990 cells through Hippo-YAP pathway

“…There were some studies supported that the level of CA19-9 was negatively correlated with survival which was an important index to reflect prognosis and recurrences [31]. Our study demonstrated that serum CA19-9 levels in cancer patients had positively correlation with YAP, and the staining intensity and extent of YAP was much higher in primary cancer tissue than in normal tissue.…”

Dissected peripancreatic tissue margin is a critical prognostic factor and is associated with a K‑ras gene mutation in pancreatic ductal adenocarcinoma

“…Similar to previous studies (23,24), preCA19-9 and DPM were identified as independent prognostic factors. The Kaplan-Meier curves of each factor are presented in Fig.…”

“…The most established biomarker for PDAC diagnosis and prognosis is preCA19-9 (14,23–28). Notably, preCA19-9 level could provide preoperative information and serve as a preoperative prognostic factor potentially able to affect the choice of treatment strategy, including the administration of neoadjuvant therapy.…”

Impact of Borderline Resectability in Pancreatic Head Cancer on Patient Survival: Biology Matters According to the New International Consensus Criteria

“…Possibly, CA19-9 serum levels might additionally help to assess the extent of lymph node metastases preoperatively. 46 The following issues need to be addressed. First, because this is a retrospective study and lost to patient follow-up was considerable, patient selection bias cannot be ruled out, especially because the approach to patients with vascular involvement changed over time to neoadjuvant therapy.…”