Combination of preoperative CEA and CA19-9 improves prediction outcomes in patients with resectable pancreatic adenocarcinoma: results from a large follow-up cohort

Abstract

Guofeng Zhou,1,2,* Xiaoyu Liu,1–4,* Xiaoyi Wang,5,* Dayong Jin,6 Yi Chen,1,2 Guoping Li,1,2 Changyu Li,1,2 Deliang Fu,5 Wanghong Xu,3,4 Xiaolin Wang1,2 1Shanghai Institute of Medical Imaging, 2Department of Interventional Radiology, Zhongshan Hospital, 3Department of Epidemiology, School of Public Health, 4Key Laboratory of Public Health Safety, Ministry of Education, 5Department of Pancreatic Surgery, Institute of Pancreatic Disease, Huashan Hospital, 6Department of Pancreatic Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies with a 5-year survival rate of <7%. Carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) are often used to predict the outcome of the malignancy independently. However, the joint prognostic effect of the two tumor biomarkers has not been well determined. The study assessed the joint role of preoperative CA19-9 and CEA in the prognostic prediction of resectable PDAC in a large cohort of patients. The study enrolled 460 eligible patients who were ready to undergo surgery for PDAC. Restricted cubic spline and direct-adjusted survival curve revealed the nonlinear association between the biomarker levels and prognosis of patients. Combination of preoperative CA19-9 and CEA effectively improved the prognostic prediction. About 100 U/mL of CA19-9 and 10 µg/mL of CEA were revealed as potential assistant index for prognostic prediction in patients with resectable PDAC and may be used as one of the criteria to assess the resectability of PDAC. Keywords: pancreatic cancer, prognosis, tumor biomarkers, CA19-9, CEA

Keywords

• pancreatic adenocarcinoma
• prognosis
• tumor biomarkers