Translational Oncology (Jan 2019)

Prognostic Impact of Presurgical CA19-9 Level in Pancreatic Adenocarcinoma: A Pooled Analysis

  • Gian Carlo Mattiucci,
  • Alessio G. Morganti,
  • Francesco Cellini,
  • Milly Buwenge,
  • Riccardo Casadei,
  • Andrea Farioli,
  • Sergio Alfieri,
  • Alessandra Arcelli,
  • Federica Bertini,
  • Felipe A. Calvo,
  • Silvia Cammelli,
  • Lorenzo Fuccio,
  • Lucia Giaccherini,
  • Alessandra Guido,
  • Joseph M. Herman,
  • Gabriella Macchia,
  • Bert W. Maidment, III,
  • Robert C. Miller,
  • Francesco Minni,
  • William F. Regine,
  • Michele Reni,
  • Stefano Partelli,
  • Massimo Falconi,
  • Vincenzo Valentini

Journal volume & issue
Vol. 12, no. 1
pp. 1 – 7

Abstract

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BACKGROUND: Presurgical carbohydrate antigen 19-9 (CA19-9) level predicts overall survival (OS) in resected pancreatic adenocarcinoma (PaC). The aim of this pooled analysis was to evaluate if presurgical CA19-9 level can also predict local control (LC) and distant metastasis-free survival (DMFS). METHODS: Seven hundred patients with PaC from eight institutions who underwent surgical resection ± adjuvant treatment between 2000 and 2014 were analyzed. Patients were divided based on four presurgical CA19-9 level cutoffs (5, 37, 100, 353 U/ml). Weibull regression model to identify independent predictors of OS on 404 patients with complete information was fitted. RESULTS: Median follow-up was 17 months (range: 2-225 months). Univariate analysis showed a better prognosis in pT1-2, pN0, diameter 353.1: 10.9%, 50.2%, and 23.4%, respectively. At multivariate analysis, CA19-9 >100 and 30 mm (P50.0 Gy showed improved OS (P<.001). CONCLUSION: Presurgical CA19-9 predicts both OS and pattern of failure. Therefore, CA19-9 should be included in predictive models in order to customize treatments based on prognostic factors. Moreover, future studies should stratify patients according to presurgical CA19-9 level.