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Preoperative Serum CA 19-9 Level as a Predictive Factor for Recurrence after Curative Resection in Biliary Tract Cancer

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Abstract

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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Conflict of interest

None of the authors have any conflict of interest to disclose.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Moon Jae Chung MD, Kyong Joo Lee MD, Seungmin Bang MD, Seung Woo Park MD, Si Young Song MD, Jae Bock Chung MD & Jeong Youp Park MD

  2. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Kyung Sik Kim MD & Woo Jung Lee MD

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  1. Moon Jae Chung MD
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  2. Kyong Joo Lee MD
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  3. Seungmin Bang MD
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  4. Seung Woo Park MD
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  5. Kyung Sik Kim MD
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  6. Woo Jung Lee MD
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  7. Si Young Song MD
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  8. Jae Bock Chung MD
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  9. Jeong Youp Park MD
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Correspondence to Jeong Youp Park MD.

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Chung, M.J., Lee, K.J., Bang, S. et al. Preoperative Serum CA 19-9 Level as a Predictive Factor for Recurrence after Curative Resection in Biliary Tract Cancer. Ann Surg Oncol 18, 1651–1656 (2011). https://doi.org/10.1245/s10434-010-1529-7

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  • DOI: https://doi.org/10.1245/s10434-010-1529-7

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