The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer.
The prognostic value of preoperative serum levels of CA 19-9 and CEA was evaluated in 160 patients with pancreatic cancer. The survival of patients whose tumour marker value was below a certain cut-off level was compared with the survival of those with a higher value using the log-rank test. The lowest cut-off level dividing patients into groups with significant difference in survival (P < 0.05) was determined by graphical analysis of chi-square values at different cut-off levels. If stage of disease was not taken into account, there was a significant difference in survival between patients with low vs high preoperative CA 19-9 and CEA levels. When patients were classified according to stage, a difference was found for CA 19-9 in stage II-III patients. Patients with preoperative CA 19-9 below 370 U ml-1 had a significantly better prognosis than those with a higher level (P < 0.05). In stage I and stage IV patients, no significant difference was found between the groups at any cut-off level. The analysis of CEA showed a significant difference in survival only in stage IV patients, with CEA above 15 ng ml-1 being associated with shorter survival. In conclusion, in patients with stage II-III disease, particularly in patients with a non-resectable tumour, in whom the exact spread of the disease may be difficult to evaluate even at operation, the preoperative CA 19-9 level seems to have a prognostic value.
Lundin
J
J
Fourth Department of Surgery, University of Helsinki, Finland.
Roberts
P J
PJ
Kuusela
P
P
Haglund
C
C
D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors
D015295:Antigens, Tumor-Associated, Carbohydrate; D002272:Carcinoembryonic Antigen