Abstract
Postoperative carbohydrate antigen 19-9 (CA19-9) is an independent predictor of survival for pancreatic ductal adenocarcinoma (PDAC), and more powerful than preoperative CA19-9. However, making decisions just dependent on postoperative CA19-9 may result in necessary treatments not being performed. A total of 178 patients with resected PDAC were eligible for this retrospective study, classified into two corresponding subgroups according to postoperative CA19-9. Prognostic significance of all clinicopathologic factors was evaluated by univariate and multivariate analyses. Postoperative CA19-9, preoperative CA125 and lymph node status were independent predictors. Better predictive performances for overall survival (OS) and recurrence-free survival (RFS) were achieved by postoperative CA19-9 compared to preoperative CA125 and lymph node status. Particularly, preoperative CA125 was associated with poor OS (p<0.001 for the normalized CA19-9 patients, p=0.012 for the elevated) and RFS (p=0.005 for the normalized, p=0.004 for the elevated). Moreover, preoperative CA125 levels related with survival in double- negative patients. Normalization of CA19-9 is not tantamount to be cured. Preoperative CA125 is a critical predictor for PDAC patients, especially in double-negative patients.
Highlights
Surgical management and adjuvant therapy develop rapidly, the prognosis of patients with resectable pancreatic ductal adenocarcinoma (PDAC) remains poor
Materials and Methods: A total of 178 patients with resected PDAC were eligible for this retrospective study, classified into two corresponding subgroups according to postoperative carbohydrate antigen 19-9 (CA19-9)
An accurate prediction of the prognosis makes a timely treatment for patients and improves their prognosis
Summary
Surgical management and adjuvant therapy develop rapidly, the prognosis of patients with resectable pancreatic ductal adenocarcinoma (PDAC) remains poor. Postoperative serum CA19-9, but not preoperative CA19-9, significantly predicted the survival of PDAC patients (Ferrone et al, 2006; Kondo et al, 2010; Motoi et al, 2011;Hata et al, 2012; Tzeng et al, 2013). Normalized postoperative CA19-9 is not tantamount to be cured It does not well evaluate the prognosis by postoperative CA19-9 alone, especially in normalized patients. Postoperative carbohydrate antigen 19-9 (CA19-9) is an independent predictor of survival for pancreatic ductal adenocarcinoma (PDAC), and more powerful than preoperative CA19-9. Better predictive performances for overall survival (OS) and recurrence-free survival (RFS) were achieved by postoperative CA19-9 compared to preoperative CA125 and lymph node status. Preoperative CA125 is a critical predictor for PDAC patients, especially in double-negative patients
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