Pretreatment CA 19-9 level as a prognostic factor in patients with advanced pancreatic cancer treated with gemcitabine
- Everardo D. SaadAffiliated withCentro Paulista de Oncologia Email author
- , Marcel C. MachadoAffiliated withUniversity of São Paulo
- , Dalia WajsbrotAffiliated withUniversity of São Paulo
- , Roberto AbramoffAffiliated withCentro Paulista de Oncologia
- , Paulo M. HoffAffiliated withCentro Paulista de Oncologia
- , Jacques TabacofAffiliated withCentro Paulista de Oncologia
- , Artur KatzAffiliated withCentro Paulista de Oncologia
- , Sergio D. SimonAffiliated withCentro Paulista de Oncologia
- , René C. GanslAffiliated withCentro Paulista de Oncologia
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Background. Serum levels of CA 19-9 correlate with survival among patients with pancreatic cancer treated with surgery or radiation therapy. In addition, CA 19-9 responses have been shown to predict for a better prognosis among patients with advanced disease treated with chemotherapy. The present study evaluates the predictive role of CA 19-9 pretreatment levels and response among patients treated with gemcitabine.
Methods. We retrospectively identified 28 patients with advanced pancreatic cancer and baseline elevations of CA 19-9 (>37 U/mL) who were treated with single agent gemcitabine. CA 19-9 response was defined as a ≥50% decline at any time after treatment. Survival was estimated with the Kaplan-Meier method, and curves were compared with the log-rank test.
Results. Eleven patients (39%) had a CA 19-9 response. The median survival of responding patients was longer than that of non-responding patients (13.8 vs 8 mo, p=.0272). When pretreatment CA 19-9 levels were analyzed, patients who had CA 19-9 below the median for the entire sample (1212 U/mL) lived significantly longer than patients with a CA 19-9 above the median (14.9 vs 7.4 mo, p=.0013). On multivariable analysis, pretreatment CA 19-9 level was an independent, and stronger predictor of survival (p=.0005) than CA 19-9 response (p=.0497). Other variables were not associated with survival.
Conclusions. CA 19-9 may be a useful adjunct to response evaluation is this setting. In addition to CA 19-9 responses, prechemotherapy levels of this marker seem to have strong prognostic significance.
Key WordsPancreatic neoplasms drug therapy CA 19-9 gemcitabine
- Pretreatment CA 19-9 level as a prognostic factor in patients with advanced pancreatic cancer treated with gemcitabine
International Journal of Gastrointestinal Cancer
Volume 32, Issue 1 , pp 35-41
- Cover Date
- Print ISSN
- Online ISSN
- Humana Press
- Additional Links
- Pancreatic neoplasms
- drug therapy
- CA 19-9
- Industry Sectors
- Author Affiliations
- 1. Centro Paulista de Oncologia, Av. Europa 105, 01449-001, São Paulo, Brazil
- 2. University of São Paulo, São Paulo, Brazil