Clinical value and impact on prognosis of peri-operative CA 19-9 serum levels in stage I and II adenocarcinoma of the pancreas.
CA 19-9 is a marker correlated to the clinical evolution of pancreatic adenocarcinoma. To analyze the clinical value of pre- and postoperative CA 19-9 serum levels in stage I and II pancreatic cancer. We analyzed 61 patients resected for pancreatic cancer. Patients were evaluated about the pre-operative CA 19-9 values and then divided into 3 groups: high, high-low and low, on the basis of pre- and postoperative CA 19-9 levels. The correlations between these groups and age, sex, pT, pN, tumor stage, jaundice, surgical radicality, tumor size, number of harvested and positive lymph nodes, grading, overall and major morbidities and post-operative mortality together with survival rates were analyzed. Higher values of pre-operative CA 19-9 were significantly correlated to the presence of jaundice, high pT, pN, stage and higher number of metastatic lymph nodes. In 49 patients (80.3 %) an R0 resection was performed. Five-year overall survival (OS) and disease free survival (DFS) were significantly better in patients with high levels of pre-operative CA 19-9, even in R0 cases. After stratification, 30 patients were included in the high group, 13 in the high-low group and 18 in the low group. A statistically significant correlation was found between the CA 19-9 groups and the lymph nodal positivity, not between CA 19-9 and pT. OS and DFS were significantly better in low group patients. We confirm the prognostic value of preoperative CA 19-9 serum levels. We do not support early postoperative modifications of CA19-9 as an adjunctive prognostic variable.
General and Minimally Invasive Surgery Unit, University of Siena, Siena, Italy.
Riccardo
R
Piagnerelli
Surgical Oncology Unit, University of Siena, Siena, Italy. daniele.marrelli@unisi.it.|, Viale M. Bracci 16, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy. daniele.marrelli@unisi.it.
Daniele
D
Marrelli
Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
Giandomenico
G
Roviello
Surgical Oncology Unit, University of Siena, Siena, Italy.
Francesco
F
Ferrara
Surgical Oncology Unit, University of Siena, Siena, Italy.
Giulio
G
Di Mare
Surgical Oncology Unit, University of Siena, Siena, Italy.
Costantino
C
Voglino
Oncology Unit, University of Siena, Siena, Italy.
Roberto
R
Petrioli
Operative Endoscopy Unit, University of Siena, Siena, Italy.
Mario
M
Marini
Operative Endoscopy Unit, University of Siena, Siena, Italy.
Raffaele
R
Macchiarelli
General and Minimally Invasive Surgery Unit, University of Siena, Siena, Italy.
Franco
F
Roviello
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen
CA 19-9; Pancreatic cancer; Pancreatic resection; Prognostic factors