Clinical value of serum CA19-9 as a prognostic factor for the ampulla of Vater carcinoma.
OBJECTIVE
Ampulla of Vater carcinoma is a relatively rare digestive tract tumor; postoperative prognostic factors have been well studied. However, any indicator of preoperative prognosis remains poorly identified. This study aims to identify serum tumor markers as preoperative prognostic factors and other variables as postoperative prognostic factors for ampulla of Vater carcinoma.


METHODS
This study retrospectively analyzed data from 26 patients undergoing pancreaticoduodenectomy (PD), including pylorus preserving PD for ampulla of Vater carcinoma between April 1993 and December 2006. The main outcome measures were survival rates of patients with and without high levels of CA19-9 and CEA.


RESULTS
Patients with high levels of CA19-9 (n = 12) had significantly higher survival rates than those without (n = 14) (p = 0.0027). High levels of CEA did not influence cumulative survival rates (p = 0.4522). Histopathological classification was an independent predictor of poor survival rates; patients with well differentiated adenocarcinoma (n = 18) had significantly higher survival rates than those with moderate to poorly differentiated tumors (n = 12) (p = 0.0280). Other factors such as tumor size, lymph node metastasis (p = 0.4006), or invasion of pancreas (p = 0.1156), duodenum (p = 0.0.3723), vein (p = 0.4331), and lymph vessel (p = 0.8606), and perineural invasion (p = 0.0.8765) were not an independent indicators of poor survival rate.


CONCLUSIONS
The results of our study indicated that high levels of CA19-9 and histopathological classification were significant independent predictors of poor survival rates for the ampulla of Vater carcinoma.
Chitaru
C
Kurihara
Fuyou
F
Yoshimi
Kazuhito
K
Sasaki
Tathuo
T
Iijima
Hiroshi
H
Kawasaki
Hideo
H
Nagai
D000230:Adenocarcinoma / Q000097:blood* / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery; D018395:CA-19-9 Antigen / Q000097:blood*; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D003138:Common Bile Duct Neoplasms / Q000097:blood* / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
D018395:CA-19-9 Antigen