Change in carbohydrate antigen 19-9 level as a prognostic marker of overall survival in locally advanced pancreatic cancer treated with concurrent chemoradiotherapy

Yi Jun Kim, Hyeon Kang Koh, Eui Kyu Chie, Do Youn Oh, Yung Jue Bang, Eun Mi Nam, Kyubo Kim

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Purpose: To investigate the significance of carbohydrate antigen 19-9 (CA19-9) levels for survival in locally advanced pancreatic cancer (LAPC) treated with concurrent chemoradiotherapy (CCRT). Methods/patients: We retrospectively reviewed data from 97 LAPC patients treated with CCRT between 2000 and 2013. CA19-9 levels (initial and post-CCRT) and their changes [{(post-CCRT CA19-9 level − initial CA19-9 level)/(initial CA19-9 level)} × 100] were analyzed for overall survival. A cut-off point of 37 U/mL was used to analyze initial and post-CCRT CA19-9 levels. In order to define an optimal cut-off point for change in CA19-9 level, the maxstat package of R was applied. Results: Median overall survival was 14.7 months (95% CI 13.4–16.0), and the 2-year survival rate was 16.5%. The estimated optimal cut-off point of CA19-9 level change was 94.4%. On univariate analyses, CA19-9 level change between initial and post-CCRT was significantly correlated with overall survival (median survival time 9.7 vs 16.3 months, p < 0.001). Multivariate analyses confirmed that CA19-9 level change from initial to post-CCRT was the only prognostic factor (p < 0.001). Conclusions: Change in CA19-9 level between initial and post-CCRT was a significant prognostic marker for overall survival in LAPC treated with CCRT. A CA19-9 level increase >94.4% might serve as a surrogate marker for poor survival in patients with LAPC undergoing CCRT, and the prognostic power surpassed other CA19-9 variables including initial and post-CCRT values.

Original languageEnglish
Pages (from-to)1069-1075
Number of pages7
JournalInternational Journal of Clinical Oncology
Volume22
Issue number6
DOIs
StatePublished - 1 Dec 2017

Keywords

  • CA19-9
  • Concurrent chemoradiotherapy
  • Locally advanced pancreatic cancer

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