Predicting Prognosis in Patients with Resectable Pancreatic Cancer Using Preoperative CA19-9 and Fecal Elastase

Abstract

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is a fatal disease. Although other studies are underway to predict the prognosis, CA19-9 is currently used to predict recurrence and survival. However, CA19-9 is not an absolute marker of the prognosis of PDAC for false negative and positive. Recently, fecal elastase-1(Fe-1), marker of pancreatic exocrine function, is known to be correlated with prognosis in PDAC patients. This study developed prediction marker of prognosis using CA19-9 and preoperative fecal elastase. Method: Clinical data of patients who underwent curative resection for PDAC in Gangnam Severance Hospital (n=95 ; 2010-2018), were reviewed. We divided four group using CA19-9 and fecal elastase-1 value. (Group 1(CA19-9>150, Fe-1 <200, n=19), Group 2(CA19-9>150, Fe-1>200,n=21), Group3(CA19-9<150, Fe-1<200,n=28), Group4(CA19-9<150, Fe-1>200,n=27) Overall survival(OS) and recurrence free survival (RFS) rates were compared using Kaplan-Meier estimates. Results: There was no statistically significant difference distributions of T stage, N stage, perineural invasion, lymphovascular invasion, cell differentiation in the four groups. However, Survival analysis showed a statistically significant difference in four groups.(p =0.021)[median survival months, mo; Group1= 7.1mo, Group2 = 11.6mo, Group3=12.6mo, Group4=15.3mo] Conclusion: Our analyses of the correlation between survival outcomes and CA19-9 and Fe-1 value in PDAC patients showed that these values were accurate and convenient prognostic indicators. We need further validation in large scale data set.