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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 levelchange 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.

Author information

Kim YJ1, Koh HK2, Chie EK3, Oh DY4, Bang YJ4, Nam EM5, Kim K6.

1
Department of Radiation Oncology, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea.
2
Department of Radiation Oncology, Konkuk University School of Medicine, Seoul, Republic of Korea.
3
Department of Radiation Oncology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. ekchie93@snu.ac.kr.
4
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
5
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
6
Department of Radiation Oncology, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea. kyubokim.ro@gmail.com.