CA 19-9 level as indicator of early distant metastasis and therapeutic selection in resected pancreatic cancer.
OBJECTIVE
In patients with pancreatic cancer treated with curative resection, we evaluated the effect of clinicopathologic parameters on early distant metastasis within 6 months (DM6m) to identify patients who might benefit from surgery.


METHODS
The study involved 84 patients with pancreatic cancer who had undergone curative resection between August 2001 and April 2009. The parameters of gender, age, tumor size, histologic differentiation, T classification, N classification, pre- and postoperative carbohydrate antigen (CA) 19-9 level, resection margin, and adjuvant chemoradiotherapy were analyzed to identify the risk factors associated with DM6m.


RESULTS
Of the 84 patients, locoregional recurrence developed in 35 (41.7%) and distant metastasis in 58 (69%). Of the 58 patients with distant metastasis, DM6m had developed in 27 (46.6%). Multivariate analysis showed that preoperative CA 19-9 level was significantly associated with DM6m (p<.05). Of all 84 patients, DM6m was observed in 9.1%, 50%, and 80% of those with a preoperative CA 19-9 level of ≤100 U/mL, 101-400 U/mL, and >400 U/mL, respectively (p<.001).


CONCLUSIONS
The preoperative CA 19-9 level might be a useful predictor of DM6m and to identify those who would benefit from surgical resection.
Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. k2onco@ncc.re.kr
Tae Hyun
TH
Kim
Sung-Sik
SS
Han
Sang-Jae
SJ
Park
Woo Jin
WJ
Lee
Sang Myung
SM
Woo
Tae
T
Yoo
Sung Ho
SH
Moon
Seong Hoon
SH
Kim
Eun Kyung
EK
Hong
Dae Yong
DY
Kim
Joong-Won
JW
Park
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018395:CA-19-9 Antigen / Q000097:blood*; D000069287:Capecitabine; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D011879:Radiotherapy Dosage; D012189:Retrospective Studies
D018395:CA-19-9 Antigen; D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil