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Tumor Biology

, Volume 37, Issue 2, pp 1959–1966 | Cite as

Clinical value and impact on prognosis of peri-operative CA 19-9 serum levels in stage I and II adenocarcinoma of the pancreas

  • Riccardo Piagnerelli
  • Daniele Marrelli
  • Giandomenico Roviello
  • Francesco Ferrara
  • Giulio Di Mare
  • Costantino Voglino
  • Roberto Petrioli
  • Mario Marini
  • Raffaele Macchiarelli
  • Franco Roviello
Original Article

Abstract

CA 19-9 is a marker correlated to the clinical evolution of pancreatic adenocarcinoma. To analyze the clinical value of pre- and postoperative CA 19-9 serum levels in stage I and II pancreatic cancer. We analyzed 61 patients resected for pancreatic cancer. Patients were evaluated about the pre-operative CA 19-9 values and then divided into 3 groups: high, high-low and low, on the basis of pre- and postoperative CA 19-9 levels. The correlations between these groups and age, sex, pT, pN, tumor stage, jaundice, surgical radicality, tumor size, number of harvested and positive lymph nodes, grading, overall and major morbidities and post-operative mortality together with survival rates were analyzed. Higher values of pre-operative CA 19-9 were significantly correlated to the presence of jaundice, high pT, pN, stage and higher number of metastatic lymph nodes. In 49 patients (80.3 %) an R0 resection was performed. Five-year overall survival (OS) and disease free survival (DFS) were significantly better in patients with high levels of pre-operative CA 19-9, even in R0 cases. After stratification, 30 patients were included in the high group, 13 in the high-low group and 18 in the low group. A statistically significant correlation was found between the CA 19-9 groups and the lymph nodal positivity, not between CA 19-9 and pT. OS and DFS were significantly better in low group patients. We confirm the prognostic value of preoperative CA 19-9 serum levels. We do not support early postoperative modifications of CA19-9 as an adjunctive prognostic variable.

Keywords

Pancreatic cancer Prognostic factors CA 19-9 Pancreatic resection 

Notes

Acknowledgments

None. No funding to declare.

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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Riccardo Piagnerelli
    • 1
  • Daniele Marrelli
    • 2
    • 6
  • Giandomenico Roviello
    • 3
  • Francesco Ferrara
    • 2
  • Giulio Di Mare
    • 2
  • Costantino Voglino
    • 2
  • Roberto Petrioli
    • 4
  • Mario Marini
    • 5
  • Raffaele Macchiarelli
    • 5
  • Franco Roviello
    • 1
  1. 1.General and Minimally Invasive Surgery UnitUniversity of SienaSienaItaly
  2. 2.Surgical Oncology UnitUniversity of SienaSienaItaly
  3. 3.Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
  4. 4.Oncology UnitUniversity of SienaSienaItaly
  5. 5.Operative Endoscopy UnitUniversity of SienaSienaItaly
  6. 6.SienaItaly

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