Serum CA19-9 determination in the management of pancreatic cancer.
OBJECTIVE
CA19-9 is a tumor marker present in the serum of 70-90% of patients with pancreatic carcinoma. In order to investigate the value of CA19-9 determination in the clinical management of patients with pancreatic cancer, we performed a retrospective study.


METHODS
We reviewed the records of 122 patients who were admitted to the Surgical Department of the Dijkzigt University Hospital in Rotterdam, the Netherlands, with a diagnosis of pancreatic cancer.


RESULTS
Patients with distant metastases at the time of diagnosis show a significantly higher serum CA19-9 level than patients without distant metastases. Unfortunately there is much overlap between the levels in both groups. There was no statistically significant difference in CA19-9 level between patients with a resectable tumor and a tumor that was unresectable due to local conditions. In the postoperative follow-up, there was a statistical relationship between the postoperative CA19-9 level and the development of distant metastases. However, since there is no known therapy for metastases of pancreatic carcinoma, it is not useful to detect these in an early stage.


CONCLUSIONS
No useful information can be obtained from postoperative CA19-9 determinations. In the preoperative workup of a patient with a pancreatic tumor CA19-9 determination is at least helpful in estimating the probability of metastatic disease.
van den Bosch
R P
RP
Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
van Eijck
C H
CH
Mulder
P G
PG
Jeekel
J
J
D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen