Preoperative serum carbohydrate antigen 19-9 levels predict early recurrence after the resection of early-stage pancreatic ductal adenocarcinoma.

Content Provider	Europe PMC
Author	Hong, Sarang Song, Ki Byung Hwang, Dae Wook Lee, Jae Hoon Lee, Woohyung Jun, Eunsung Kwon, Jaewoo Park, Yejong Park, Seo Young Kim, Naru Shin, Dakyum Kim, Hyeyeon Sung, Minkyu Ryu, Yunbeom Kim, Song Cheol
Copyright Year	2021
Abstract	BACKGROUNDPancreatic ductal adenocarcinoma (PDAC) is a serious disease with a poor prognosis. Only a minority of patients undergo surgery due to the advanced stage of the disease, and patients with early-stage disease, who are expected to have a better prognosis, often experience recurrence. Thus, it is important to identify the risk factors for early recurrence and to develop an adequate treatment plan.AIMTo evaluate the predictive factors associated with the early recurrence of early-stage PDAC.METHODSThis study enrolled 407 patients with stage I PDAC undergoing upfront surgical resection between January 2000 and April 2016. Early recurrence was defined as a diagnosis of recurrence within 6 mo of surgery. The optimal cutoff values were determined by receiver operating characteristic (ROC) analyses. Univariate and multivariate analyses were performed to identify the risk factors for early recurrence.RESULTSOf the 407 patients, 98 patients (24.1%) experienced early disease recurrence: 26 (26.5%) local and 72 (73.5%) distant sites. In total, 253 (62.2%) patients received adjuvant chemotherapy. On ROC curve analysis, the optimal cutoff values for early recurrence were 70 U/mL and 2.85 cm for carbohydrate antigen 19-9 (CA 19-9) levels and tumor size, respectively. Of the 181 patients with CA 19-9 level > 70 U/mL, 59 (32.6%) had early recurrence, compared to 39 (17.4%) of 226 patients with CA 19-9 level ≤ 70 U/mL (P < 0.001). Multivariate analysis revealed that CA 19-9 level > 70 U/mL (P = 0.006), tumor size > 2.85 cm (P = 0.004), poor differentiation (P = 0.008), and non-adjuvant chemotherapy (P = 0.025) were significant risk factors for early recurrence in early-stage PDAC.CONCLUSIONElevated CA 19-9 level (cutoff value > 70 U/mL) can be a reliable predictive factor for early recurrence in early-stage PDAC. As adjuvant chemotherapy can prevent early recurrence, it should be recommended for patients susceptible to early recurrence.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8649558&blobtype=pdf
Journal	World Journal of Gastrointestinal Surgery [World J Gastrointest Surg]
Volume Number	13
DOI	10.4240/wjgs.v13.i11.1423
PubMed Central reference number	PMC8649558
Issue Number	11
PubMed reference number	34950431
e-ISSN	19489366
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2021-11-01
Access Restriction	Open
Rights License	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Pancreatic ductal adenocarcinoma Early recurrence Upfront surgery Carbohydrate antigen 19-9 Adjuvant chemotherapy
Content Type	Text
Resource Type	Article
Subject	Gastroenterology