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Preoperative serum CA 19-9 level as a predictive factor for recurrence after curative resection in biliary tract cancer.

 Moon Jae Chung  ;  Kyong Joo Lee  ;  Seungmin Bang  ;  Seung Woo Park  ;  Kyung Sik Kim  ;  Woo Jung Lee  ;  Si Young Song  ;  Jae Bock Chung  ;  Jeong Youp Park 
 ANNALS OF SURGICAL ONCOLOGY, Vol.18(6) : 1651-1656, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Biliary Tract Neoplasms/blood* ; Biliary Tract Neoplasms/surgery* ; Biomarkers, Tumor/blood* ; CA-19-9 Antigen/blood* ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/blood* ; Neoplasm Recurrence, Local/diagnosis* ; Postoperative Complications* ; Preoperative Care ; Prognosis ; Retrospective Studies
Curative Resection ; Gallbladder Cancer ; Carbohydrate Antigen ; Preoperative Serum ; Biliary Tract Cancer
BACKGROUND: Complete surgical removal of biliary tract cancer (BTC) offers the only chance of cure; however, long-term survival remains very limited because of frequent recurrence after surgery. The purpose of our study was to evaluate whether the preoperative serum carbohydrate antigen (CA) 19-9 level could predict recurrence after curative resection of BTC.

METHODS: We performed a retrospective review of the medical records of patients who were diagnosed with BTC and underwent curative resection. The optimal cutoff value for the preoperative serum level of CA 19-9 that predicted recurrence was determined by a ROC curve. Preoperative and postoperative risk factors for recurrence were evaluated using log-rank test.

RESULTS: A total of 101 patients were eligible for this study. The optimal cutoff value of preoperative serum CA 19-9 level to predict recurrence was 55 U/mL. Forty-five patients (44.6%) experienced recurrence after curative resection with a median follow-up period of 28.4 months. Recurrence occurred in 33 (61.1%) of 54 patients with CA 19-9 levels ≥55 U/mL compared with only 12 (25.5%) of 47 patients with CA 19-9 levels <55 U/mL. The recurrence rate was significantly higher in patients with baseline CA 19-9 serum levels ≥55 U/mL (hazard ratio, 3.282; 95% confidence interval, 1.684-6.395; P < 0.001).

CONCLUSIONS: Elevated preoperative serum CA 19-9 was associated with a high risk of recurrence after curative resection of BTC. Different treatment plans might be needed for patients with BTC and high serum levels of CA 19-9.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Lee, Kyong Joo(이경주)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
Chung, Jae Bock(정재복)
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