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The Use of Adjusted Preoperative CA 19-9 to Predict the Recurrence of Resectable Pancreatic Cancer

 Chang Moo Kang  ;  Jun Young Kim  ;  Byong Ro Kim  ;  Woo Jung Lee  ;  Jin Sub Choi  ;  Kyung Sik Kim  ;  Gi Hong Choi 
 JOURNAL OF SURGICAL RESEARCH, Vol.140(1) : 31-35, 2007 
Journal Title
Issue Date
Adenocarcinoma/blood ; Adenocarcinoma/diagnosis* ; Adenocarcinoma/epidemiology ; Adenocarcinoma/surgery* ; Aged ; Biomarkers, Tumor/blood ; CA-19-9 Antigen/blood* ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local/blood ; Neoplasm Recurrence, Local/diagnosis* ; Neoplasm Recurrence, Local/epidemiology ; Pancreatic Neoplasms/blood ; Pancreatic Neoplasms/diagnosis* ; Pancreatic Neoplasms/epidemiology ; Pancreatic Neoplasms/surgery* ; Predictive Value of Tests ; Preoperative Care ; Prognosis ; Retrospective Studies ; Risk Factors
BACKGROUND: Despite the usefulness of CA 19-9 in the diagnosis and prognosis of pancreatic cancer, cholestasis can falsely elevate CA 19-9 levels, which contributes to limited clinical utility in patients with biliary obstruction. This study was designed to evaluate the usefulness of adjusted preoperative CA 19-9 levels in predicting a prognosis of pancreatic cancer. METHODS: The available medical records of patients with resected pancreatic cancer from January 1990 to June 2005 were retrospectively viewed at Yonsei Medical Center, Seoul, Korea. The adjusted CA 19-9 value was obtained by dividing the serum CA 19-9 level by the values of serum bilirubin in case of bilirubin greater, similar 2 mg/dL. Disease-free survival was evaluated according to the adjusted preoperative CA 19-9 value. RESULTS: Sixty-one patients were investigated. Their adjusted preoperative CA 19-9 values were significantly different from the actual baseline CA 19-9 value (129.4 +/- 225.2 U/mL, versus 442.1 +/- 645.5 U/mL, P < 0.0001). On univariate analysis, peripancreatic microscopic invasion (P = 0.0142), lymphovascular invasion (P = 0.0038), and adjusted preoperative CA 19-9 > or = 50 U/mL (P = 0.0049) were predictive factors for cancer recurrence after curative resection. Adjusted preoperative CA 19-9 > or = 50 U/mL (Exp (B) = 2.097, P = 0.027) was an independent predictive factor in multivariate analysis. CONCLUSIONS: The adjusted preoperative CA 19-9 value can predict the risk of recurrence after curative resection of pancreatic cancer. Interpreting the preoperative CA 19-9 value adjusted to the serum bilirubin values seems to be more reasonable in evaluating prognosis of pancreatic cancer.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Byong Ro(김병로)
Kim, Jun Young(김준영)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
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