Background
Carbohydrate antigen (CA19-9) is a well-established marker to monitor disease status
after resection of pancreatic cancer. However, few serum markers have been reported
to improve the prognostic ability of postoperative CA19-9, especially in patients
with normal postoperative CA19-9.
Methods
A total of 353 patients with pancreatic ductal adenocarcinoma treated by radical resection
were reviewed retrospectively, and a prospective cohort including 142 patients with
resectable pancreatic head carcinoma was analyzed as a validation cohort. Perioperative
CA19-9 and postoperative serum markers (CEA, CA242, CA72-4, CA50, CA125, CA153, and
AFP) were investigated.
Results
Patients with postoperative normalization of CA19-9 had improved survival times (recurrence-free
survival: 11.9 months; overall survival: 22.5 months) compared with those with decreased
but still elevated postoperative CA19-9 (recurrence-free survival: 6.8 months, P < .001; overall survival: 13.5 months, P < .001) or those with increased postoperative CA19-9 (recurrence-free survival: 3.5 months,
P < .001; overall survival: 7.9 months, P < .001), which was similar to those with consistently normal CA19-9 during perioperative
periods (recurrence-free survival: 10.6 months, P = .799; overall survival: 24.1 months, P = .756). Normal postoperative CA19-9 levels were an independent indicator for a positive
outcome after operation, regardless of preoperative CA19-9 levels. Elevated postoperative
CEA and CA125 were identified further as independent risk factors for patients with
normal postoperative CA19-9, while elevated postoperative CA125 and nondecreased postoperative
CA19-9 were independent prognostic markers for patients with elevated postoperative
CA19-9.
Conclusion
The postoperative monitoring of CEA and CA125 provided prognostic significance to
the measurement of CA19-9 in pancreatic cancer after resection.
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Article info
Publication history
Published online: November 09, 2016
Accepted:
August 3,
2016
Footnotes
Supported by grants from the National Science Foundation for Distinguished Young Scholars of China (81625016), the National Natural Science Foundation of China (81472670, 81172005, 81402397, 81402398, and 81172276), the National Natural Science Foundation of Shanghai (14ZR1407600), and the “Yang-Fan” Plan for Young Scientists of Shanghai (14YF1401100). The funding agencies had no role in study design, data collection and analyses, decision to publish, or preparation of the manuscript.
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Copyright
© 2016 Published by Elsevier Inc.
