Elevated Serum CA19-9 Level Is A Promising Predictor For Poor ...

Pancreatic cancer is one of the most aggressive human cancers and is characterized by a rapid tumor spread and a dismal prognosis [1]. By the time of diagnosis, fewer than 15% of patients can be offered a potential curative treatment, and up to 30% of the patients die within 12 months [2, 3]. Additionally, the 5-year survival rate of patients with potentially resectable pancreatic cancer was reported not to exceed 20% [4]. It is extremely important to precisely predict the prognosis after tumor resection for the assessment of the therapeutic effect, for the consideration of administering adjuvant therapy, and to provide information to patients.

To date, several studies have reported that the preoperative carbohydrate antigen 19-9 (CA19-9) level, which is a tumor-associated antigen that requires the expression of a sialylated Lewis blood group antigen for expression, is a useful marker for predicting prognosis after resection [5–13]. However, the cutoff value of CA19-9 used to predict prognosis varied among these reports. A value of 37 U/mL has been frequently used as the cutoff value in previous studies [7, 10, 14, 15]. The normal physiological level of serum CA19-9 is defined as under 37 U/mL, which was estimated based on the standard deviation of the distribution of serum CA19-9 levels among normal persons. Serum CA19-9 levels are elevated in 70% to 80% of pancreatic cancer patients [16] and may be more suitable for the diagnosis of pancreatic cancer rather than for predicting the prognosis for the patients with established diagnosis. Thus, it is still uncommon for clinicians to predict prognosis with preoperative CA19-9 values.

The aims of this study were to evaluate whether the preoperative CA19-9 value is a significant predictor for survival and to determine the optimal cutoff value of CA19-9 for predicting the prognosis in PDAC.