title: Serum CA19-9 is a significant predictor among preoperative parameters for early recurrence after resection of pancreatic adenocarcinoma.
abstract: OBJECTIVE
  To evaluate the preoperative factors predictive of postoperative early recurrence in patients with resected pancreatic cancer focusing on the serum CA19-9 value.
  
  
  METHODS
  One hundred fifty-four patients undergoing surgical resection for pancreatic cancer were enrolled in this study. Univariate and multivariate analyses were performed to determine the predictors of early recurrence which was defined as relapse within 6 months after surgery.
  
  
  RESULTS
  On ROC curve analysis, the cutoff value of CA19-9 was determined to be 100 U/ml. Of 73 patients with CA19-9 value ≥ 100 U/ml, 39 (53 %) had early recurrence. In contrast, only 9 of 81 patients (11 %) with CA19-9 value < 100 U/ml developed a recurrence at an early period (p < 0.001). Multivariate analysis revealed that CA19-9 value ≥ 100 U/ml (odds ratio, 11.2) were significant predictors of early recurrence. The overall 3- and 5-year survival rates and median survival times were 47.3 %, 40.1 %, and 31 months in patients with CA19-9 value < 100 U/ml and 21.2 %, 9.4 %, and 16 months in patients with CA19-9 value ≥ 100 U/ml (p < 0.001).
  
  
  CONCLUSIONS
  A preoperative CA19-9 value ≥ 100 U/ml was a significant predictor of early recurrence and a poor prognosis after resection for pancreatic adenocarcinoma.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan. t.sugiura@scchr.jp
authors.forename: Teiichi
authors.initials: T
authors.lastname: Sugiura
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Uesaka
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kanemoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizuno
authors.forename: Keiko
authors.initials: K
authors.lastname: Sasaki
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Kazuya
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Maeda
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood* / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen