Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation
Purpose The role of carbohydrate antigen (CA) 19-9 in the evaluation of patients with resectable pancreatic cancer treated with neoadjuvant therapy prior to planned surgical resection is unknown. We evaluated CA 19-9 as a marker of therapeutic response, completion of therapy, and survival in patient...
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| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , , , , , , , , |
| التنسيق: | article |
| منشور في: |
2010
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| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/2617 http://dx.doi.org/10.1245/s10434-010-0943-1 |
| الوسوم: |
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| _version_ | 1864513458729385984 |
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| author | Katz, Matthew |
| author2 | Varadhachary, Gauri Fleming, Jason Wolff, Robert Lee, Jeffrey Pisters, Peter Vauthey, Jean-Nicolas Abdalla, Eddie Sun, Charlotte Wang, Huamin Crane, Christopher Tamm, Eric Abbruzzese, James Evans, Douglas |
| author2_role | author author author author author author author author author author author author author |
| author_facet | Katz, Matthew Varadhachary, Gauri Fleming, Jason Wolff, Robert Lee, Jeffrey Pisters, Peter Vauthey, Jean-Nicolas Abdalla, Eddie Sun, Charlotte Wang, Huamin Crane, Christopher Tamm, Eric Abbruzzese, James Evans, Douglas |
| author_role | author |
| dc.creator.none.fl_str_mv | Katz, Matthew Varadhachary, Gauri Fleming, Jason Wolff, Robert Lee, Jeffrey Pisters, Peter Vauthey, Jean-Nicolas Abdalla, Eddie Sun, Charlotte Wang, Huamin Crane, Christopher Lee, Jeffrey Tamm, Eric Abbruzzese, James Evans, Douglas |
| dc.date.none.fl_str_mv | 2010 2015-11-19T08:34:45Z 2015-11-19T08:34:45Z 2015-11-19 |
| dc.identifier.none.fl_str_mv | 1068-9265 http://hdl.handle.net/10725/2617 http://dx.doi.org/10.1245/s10434-010-0943-1 Katz, M. H., Varadhachary, G. R., Fleming, J. B., Wolff, R. A., Lee, J. E., Pisters, P. W., ... & Evans, D. B. (2010). Serum CA 19-9 as a marker of resectability and survival in patients with potentially resectable pancreatic cancer treated with neoadjuvant chemoradiation. Annals of surgical oncology, 17(7), 1794-1801. |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Annals of Surgical Oncology |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Purpose The role of carbohydrate antigen (CA) 19-9 in the evaluation of patients with resectable pancreatic cancer treated with neoadjuvant therapy prior to planned surgical resection is unknown. We evaluated CA 19-9 as a marker of therapeutic response, completion of therapy, and survival in patients enrolled on two recently reported clinical trials. Patients and Methods We analyzed patients with radiographically resectable adenocarcinoma of the head/uncinate process treated on two phase II trials of neoadjuvant chemoradiation. Patients without evidence of disease progression following chemoradiation underwent pancreaticoduodenectomy (PD). CA 19-9 was evaluated in patients with a normal bilirubin level. Results We enrolled 174 patients, and 119 (68%) completed all therapy including PD. Pretreatment CA 19-9 <37 U/ml had a positive predictive value (PPV) for completing PD of 86% but a negative predictive value (NPV) of 33%. Among patients without evidence of disease at last follow-up, the highest pretreatment CA 19-9 was 1,125 U/ml. Restaging CA 19-9 <61 U/ml had a PPV of 93% and a NPV of 28% for completing PD among resectable patients. The area under the receiver-operating characteristics curve of pretreatment and restaging CA 19-9 levels for completing PD was 0.59 and 0.74, respectively. We identified no association between change in CA 19-9 and histopathologic response (P = 0.74). Conclusions Although the PPV of CA 19-9 for completing neoadjuvant therapy and undergoing PD was high, its clinical utility was compromised by a low NPV. Decision-making for patients with resectable PC should remain based on clinical assessment and radiographic staging. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_2215eef4e21a9442783f5ba8dfdaadaa |
| identifier_str_mv | 1068-9265 Katz, M. H., Varadhachary, G. R., Fleming, J. B., Wolff, R. A., Lee, J. E., Pisters, P. W., ... & Evans, D. B. (2010). Serum CA 19-9 as a marker of resectability and survival in patients with potentially resectable pancreatic cancer treated with neoadjuvant chemoradiation. Annals of surgical oncology, 17(7), 1794-1801. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2617 |
| publishDate | 2010 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant ChemoradiationKatz, MatthewVaradhachary, GauriFleming, JasonWolff, RobertLee, JeffreyPisters, PeterVauthey, Jean-NicolasAbdalla, EddieSun, CharlotteWang, HuaminCrane, ChristopherLee, JeffreyTamm, EricAbbruzzese, JamesEvans, DouglasPurpose The role of carbohydrate antigen (CA) 19-9 in the evaluation of patients with resectable pancreatic cancer treated with neoadjuvant therapy prior to planned surgical resection is unknown. We evaluated CA 19-9 as a marker of therapeutic response, completion of therapy, and survival in patients enrolled on two recently reported clinical trials. Patients and Methods We analyzed patients with radiographically resectable adenocarcinoma of the head/uncinate process treated on two phase II trials of neoadjuvant chemoradiation. Patients without evidence of disease progression following chemoradiation underwent pancreaticoduodenectomy (PD). CA 19-9 was evaluated in patients with a normal bilirubin level. Results We enrolled 174 patients, and 119 (68%) completed all therapy including PD. Pretreatment CA 19-9 <37 U/ml had a positive predictive value (PPV) for completing PD of 86% but a negative predictive value (NPV) of 33%. Among patients without evidence of disease at last follow-up, the highest pretreatment CA 19-9 was 1,125 U/ml. Restaging CA 19-9 <61 U/ml had a PPV of 93% and a NPV of 28% for completing PD among resectable patients. The area under the receiver-operating characteristics curve of pretreatment and restaging CA 19-9 levels for completing PD was 0.59 and 0.74, respectively. We identified no association between change in CA 19-9 and histopathologic response (P = 0.74). Conclusions Although the PPV of CA 19-9 for completing neoadjuvant therapy and undergoing PD was high, its clinical utility was compromised by a low NPV. Decision-making for patients with resectable PC should remain based on clinical assessment and radiographic staging.PublishedN/A2015-11-19T08:34:45Z2015-11-19T08:34:45Z20102015-11-19Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1068-9265http://hdl.handle.net/10725/2617http://dx.doi.org/10.1245/s10434-010-0943-1Katz, M. H., Varadhachary, G. R., Fleming, J. B., Wolff, R. A., Lee, J. E., Pisters, P. W., ... & Evans, D. B. (2010). Serum CA 19-9 as a marker of resectability and survival in patients with potentially resectable pancreatic cancer treated with neoadjuvant chemoradiation. Annals of surgical oncology, 17(7), 1794-1801.enAnnals of Surgical Oncologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26172019-02-26T10:57:01Z |
| spellingShingle | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation Katz, Matthew |
| status_str | publishedVersion |
| title | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation |
| title_full | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation |
| title_fullStr | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation |
| title_full_unstemmed | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation |
| title_short | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation |
| title_sort | Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation |
| url | http://hdl.handle.net/10725/2617 http://dx.doi.org/10.1245/s10434-010-0943-1 |