Preoperative CA 19-9 Level Is an Important Prognostic Factor in Patients With Pancreatic Adenocarcinoma Treated With Surgical Resection and Adjuvant Concurrent Chemoradiotherapy

Hallemeier, Christopher L.; Botros, Maikel; Corsini, Michele M.; Haddock, Michael G.; Gunderson, Leonard L.; Miller, Robert C.

doi:10.1097/coc.0b013e3181f946fc

Cited by 46 publications

(27 citation statements)

References 15 publications

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“…19,20 One series from the Mayo Clinic examined prognostic factors in their patients resected between 1995 and 2005, finding that 46% (69 of 151) patients did not receive systemic therapy. 21 One potential advantage of a neoadjuvant approach for chemotherapy in this group of patients is that more patients actually receive their systemic therapy; usually about 80-90% of patients with resectable tumors that receive neoadjuvant therapy with intent of getting to resection are able to undergo R0 or R1 resection. 19 This NCDB review suggests that total pancreatectomy should be a consideration for selected patients with pancreatic ductal adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Total pancreatectomy for pancreatic ductal adenocarcinoma: review of the National Cancer Data Base

Johnston

Hoen

Cassera

et al. 2016

HPB

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Section: Discussionmentioning

confidence: 99%

Total pancreatectomy for pancreatic ductal adenocarcinoma: review of the National Cancer Data Base

Johnston

Hoen

Cassera

et al. 2016

HPB

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“…None of the six patients had a significant increase in CA 19.9 levels at the time of diagnosis of the new hepatic lesions. Although, CA 19.9 was elevated in two patients, this raised the suspicion of progression or relapse of PDAC; however, and CA 19.9 increase can also be due to non-oncological causes, such as cholangitis and jaundice [12]. Furthermore, in these two patients that CA 19.9 was elevated, it was lower compared to prior measurement (one patient – case 6 had a significant reduction in compared to the previous exam), which makes the hypothesis of progression of neoplastic disease less likely.…”

Section: Discussionmentioning

confidence: 99%

Subclinical focal cholangitis mimicking liver metastasis in asymptomatic patients with history of pancreatic ductal adenocarcinoma and biliary tree intervention

et al. 2017

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BackgroundCholangitis is an inflammatory process of the biliary tract with a wide range of clinical manifestations and it is not always considered in the differential diagnosis in asymptomatic patients. To the best of our knowledge there is no previous report in the English literature of focal cholangitis manifesting exclusively as liver parenchymal changes mimicking liver metastasis in asymptomatic patients with pancreatic ductal adenocarcinoma (PDAC) and history of manipulation of the biliary tree. The purpose of this article is to present six cases of subclinical focal cholangitis mimicking liver metastasis in asymptomatic patients with history of PDAC and biliary tree intervention.Case presentationThere are six cases with new hepatic lesions detected on follow-up scans in asymptomatic patients with history of PDAC and manipulation of biliary tree. Overall seven lesions were detected, all of them were on the liver periphery, five were hypovascular and two were hypervascular. None of those patients had elevation of CA 19.9 compared with the previous exams. The three patients that had magnetic resonance imaging presented restriction on diffusion weighted imaging and high signal intensity on T2-weighted image. Two patients underwent liver biopsy, which showed only inflammatory changes. All patients were treated with antibiotics and underwent imaging follow-up, which demonstrated resolution of the lesions. None of the patients showed imaging or clinical signs of disease progression during this interval.ConclusionRadiologists and oncologists need to be aware of the possibility of focal cholangitis causing hepatic lesions mimicking neoplasia in patients with history of biliary tree intervention, even in the absence of clinical symptoms.

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“…Abnormal CA19-9 serum levels were also found in patients with cholangiocarcinoma [26], colorectal cancer [27], gastric cancer [28], and a wide range of benign conditions, such as liver diseases, ascending cholangitis, and pancreatitis [29]. The preoperative CA19-9 level has been reported to be a prognostic factor for pancreatic cancer [30] and cholangiocarcinoma [31]. CA19-9 serum level has been reported to be elevated in HCC patients, but the prognostic implication is still unknown.…”

Section: Discussionmentioning

confidence: 99%

Elevated Preoperative Serum CA19‐9 Levels in Patients with Hepatocellular Carcinoma Is Associated with Poor Prognosis after Resection

Chen

et al. 2013

The Scientific World Journal

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Serum levels of the tumor marker CA19-9 have been reported to be elevated in patients with hepatocellular carcinoma (HCC), but its clinicopathologic significance is still unknown. A cohort of 304 patients undergoing surgical resection for HCC and having preoperative CA19-9 data was enrolled in this study. Serum CA19-9 levels were correlated with clinicopathologic factors. Univariate and multivariate analyses were performed to determine the predictors of patient survival. On receiver operating characteristic curve analysis, the cut off value of CA19-9 was determined to be 27 U/mL. One hundred and six patients had preoperative CA19-9 values >27 U/mL. High serum CA19-9 levels did not correlate with patient age, sex, viral status, α-fetoprotein level, tumor size, tumor grade, tumor stage, multiplicity, and vascular invasion. Patients with elevated preoperative CA19-9 levels had lower 10-year survival than those without CA19-9 elevation. Multivariate analysis revealed that CA19-9 level, tumor grade, and tumor size are independent prognostic factors for long-term survival. In conclusion, a preoperative CA19-9 value >27 U/mL is associated with poor prognosis after resection for HCC.

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Preoperative CA 19-9 Level Is an Important Prognostic Factor in Patients With Pancreatic Adenocarcinoma Treated With Surgical Resection and Adjuvant Concurrent Chemoradiotherapy

Cited by 46 publications

References 15 publications

Total pancreatectomy for pancreatic ductal adenocarcinoma: review of the National Cancer Data Base

Total pancreatectomy for pancreatic ductal adenocarcinoma: review of the National Cancer Data Base

Subclinical focal cholangitis mimicking liver metastasis in asymptomatic patients with history of pancreatic ductal adenocarcinoma and biliary tree intervention

Elevated Preoperative Serum CA19‐9 Levels in Patients with Hepatocellular Carcinoma Is Associated with Poor Prognosis after Resection

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