The Use of Adjusted Preoperative CA 19-9 to Predict the Recurrence of Resectable Pancreatic Cancer

ChangMoo Kang, Jun Young Kim, Gi Hong Choi, Kyung Sik Kim, Jin Sub Choi, Woo Jung Lee, Byong Ro Kim

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Abstract

Background: Despite the usefulness of CA 19-9 in the diagnosis and prognosis of pancreatic cancer, cholestasis can falsely elevate CA 19-9 levels, which contributes to limited clinical utility in patients with biliary obstruction. This study was designed to evaluate the usefulness of adjusted preoperative CA 19-9 levels in predicting a prognosis of pancreatic cancer. Methods: The available medical records of patients with resected pancreatic cancer from January 1990 to June 2005 were retrospectively viewed at Yonsei Medical Center, Seoul, Korea. The adjusted CA 19-9 value was obtained by dividing the serum CA 19-9 level by the values of serum bilirubin in case of bilirubin ≳2 mg/dL. Disease-free survival was evaluated according to the adjusted preoperative CA 19-9 value. Results: Sixty-one patients were investigated. Their adjusted preoperative CA 19-9 values were significantly different from the actual baseline CA 19-9 value (129.4 ± 225.2 U/mL, versus 442.1 ± 645.5 U/mL, P < 0.0001). On univariate analysis, peripancreatic microscopic invasion (P = 0.0142), lymphovascular invasion (P = 0.0038), and adjusted preoperative CA 19-9 ≥ 50 U/mL (P = 0.0049) were predictive factors for cancer recurrence after curative resection. Adjusted preoperative CA 19-9 ≥ 50 U/mL (Exp (B) = 2.097, P = 0.027) was an independent predictive factor in multivariate analysis. Conclusions: The adjusted preoperative CA 19-9 value can predict the risk of recurrence after curative resection of pancreatic cancer. Interpreting the preoperative CA 19-9 value adjusted to the serum bilirubin values seems to be more reasonable in evaluating prognosis of pancreatic cancer.

Original languageEnglish
Pages (from-to)31-35
Number of pages5
JournalJournal of Surgical Research
Volume140
Issue number1
DOIs
Publication statusPublished - 2007 Jun 1

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Pancreatic Neoplasms
Recurrence
Bilirubin
Serum
Cholestasis
Korea
Disease-Free Survival
Medical Records
Multivariate Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kang, ChangMoo ; Kim, Jun Young ; Choi, Gi Hong ; Kim, Kyung Sik ; Choi, Jin Sub ; Lee, Woo Jung ; Kim, Byong Ro. / The Use of Adjusted Preoperative CA 19-9 to Predict the Recurrence of Resectable Pancreatic Cancer. In: Journal of Surgical Research. 2007 ; Vol. 140, No. 1. pp. 31-35.
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title = "The Use of Adjusted Preoperative CA 19-9 to Predict the Recurrence of Resectable Pancreatic Cancer",
abstract = "Background: Despite the usefulness of CA 19-9 in the diagnosis and prognosis of pancreatic cancer, cholestasis can falsely elevate CA 19-9 levels, which contributes to limited clinical utility in patients with biliary obstruction. This study was designed to evaluate the usefulness of adjusted preoperative CA 19-9 levels in predicting a prognosis of pancreatic cancer. Methods: The available medical records of patients with resected pancreatic cancer from January 1990 to June 2005 were retrospectively viewed at Yonsei Medical Center, Seoul, Korea. The adjusted CA 19-9 value was obtained by dividing the serum CA 19-9 level by the values of serum bilirubin in case of bilirubin ≳2 mg/dL. Disease-free survival was evaluated according to the adjusted preoperative CA 19-9 value. Results: Sixty-one patients were investigated. Their adjusted preoperative CA 19-9 values were significantly different from the actual baseline CA 19-9 value (129.4 ± 225.2 U/mL, versus 442.1 ± 645.5 U/mL, P < 0.0001). On univariate analysis, peripancreatic microscopic invasion (P = 0.0142), lymphovascular invasion (P = 0.0038), and adjusted preoperative CA 19-9 ≥ 50 U/mL (P = 0.0049) were predictive factors for cancer recurrence after curative resection. Adjusted preoperative CA 19-9 ≥ 50 U/mL (Exp (B) = 2.097, P = 0.027) was an independent predictive factor in multivariate analysis. Conclusions: The adjusted preoperative CA 19-9 value can predict the risk of recurrence after curative resection of pancreatic cancer. Interpreting the preoperative CA 19-9 value adjusted to the serum bilirubin values seems to be more reasonable in evaluating prognosis of pancreatic cancer.",
author = "ChangMoo Kang and Kim, {Jun Young} and Choi, {Gi Hong} and Kim, {Kyung Sik} and Choi, {Jin Sub} and Lee, {Woo Jung} and Kim, {Byong Ro}",
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The Use of Adjusted Preoperative CA 19-9 to Predict the Recurrence of Resectable Pancreatic Cancer. / Kang, ChangMoo; Kim, Jun Young; Choi, Gi Hong; Kim, Kyung Sik; Choi, Jin Sub; Lee, Woo Jung; Kim, Byong Ro.

In: Journal of Surgical Research, Vol. 140, No. 1, 01.06.2007, p. 31-35.

Research output: Contribution to journalArticle

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AU - Choi, Jin Sub

AU - Lee, Woo Jung

AU - Kim, Byong Ro

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N2 - Background: Despite the usefulness of CA 19-9 in the diagnosis and prognosis of pancreatic cancer, cholestasis can falsely elevate CA 19-9 levels, which contributes to limited clinical utility in patients with biliary obstruction. This study was designed to evaluate the usefulness of adjusted preoperative CA 19-9 levels in predicting a prognosis of pancreatic cancer. Methods: The available medical records of patients with resected pancreatic cancer from January 1990 to June 2005 were retrospectively viewed at Yonsei Medical Center, Seoul, Korea. The adjusted CA 19-9 value was obtained by dividing the serum CA 19-9 level by the values of serum bilirubin in case of bilirubin ≳2 mg/dL. Disease-free survival was evaluated according to the adjusted preoperative CA 19-9 value. Results: Sixty-one patients were investigated. Their adjusted preoperative CA 19-9 values were significantly different from the actual baseline CA 19-9 value (129.4 ± 225.2 U/mL, versus 442.1 ± 645.5 U/mL, P < 0.0001). On univariate analysis, peripancreatic microscopic invasion (P = 0.0142), lymphovascular invasion (P = 0.0038), and adjusted preoperative CA 19-9 ≥ 50 U/mL (P = 0.0049) were predictive factors for cancer recurrence after curative resection. Adjusted preoperative CA 19-9 ≥ 50 U/mL (Exp (B) = 2.097, P = 0.027) was an independent predictive factor in multivariate analysis. Conclusions: The adjusted preoperative CA 19-9 value can predict the risk of recurrence after curative resection of pancreatic cancer. Interpreting the preoperative CA 19-9 value adjusted to the serum bilirubin values seems to be more reasonable in evaluating prognosis of pancreatic cancer.

AB - Background: Despite the usefulness of CA 19-9 in the diagnosis and prognosis of pancreatic cancer, cholestasis can falsely elevate CA 19-9 levels, which contributes to limited clinical utility in patients with biliary obstruction. This study was designed to evaluate the usefulness of adjusted preoperative CA 19-9 levels in predicting a prognosis of pancreatic cancer. Methods: The available medical records of patients with resected pancreatic cancer from January 1990 to June 2005 were retrospectively viewed at Yonsei Medical Center, Seoul, Korea. The adjusted CA 19-9 value was obtained by dividing the serum CA 19-9 level by the values of serum bilirubin in case of bilirubin ≳2 mg/dL. Disease-free survival was evaluated according to the adjusted preoperative CA 19-9 value. Results: Sixty-one patients were investigated. Their adjusted preoperative CA 19-9 values were significantly different from the actual baseline CA 19-9 value (129.4 ± 225.2 U/mL, versus 442.1 ± 645.5 U/mL, P < 0.0001). On univariate analysis, peripancreatic microscopic invasion (P = 0.0142), lymphovascular invasion (P = 0.0038), and adjusted preoperative CA 19-9 ≥ 50 U/mL (P = 0.0049) were predictive factors for cancer recurrence after curative resection. Adjusted preoperative CA 19-9 ≥ 50 U/mL (Exp (B) = 2.097, P = 0.027) was an independent predictive factor in multivariate analysis. Conclusions: The adjusted preoperative CA 19-9 value can predict the risk of recurrence after curative resection of pancreatic cancer. Interpreting the preoperative CA 19-9 value adjusted to the serum bilirubin values seems to be more reasonable in evaluating prognosis of pancreatic cancer.

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