1. CA19-9 capability as predictor of pancreatic cancer resectability in a Spanish cohort
- Author
-
Agueda Iglesias-Gómez, María Francisco, Emma Martínez Moneo, Luis Bujanda, Marta García-Cougil, Mario Rodríguez-López, Lourdes Ruiz-Rebollo, E Iyo, Emilio Garabitos, Maider Martos, Mario Montes, Marta Herreros-Villanueva, Ibon Martínez-Arranz, Joaquín Cubiella, and Enrique de Madaria
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,CA-19-9 Antigen ,endocrine system diseases ,Unresectable disease ,Adenocarcinoma ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Borderline resectable ,Internal medicine ,Pancreatic cancer ,Biomarkers, Tumor ,Genetics ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Molecular Biology ,Aged ,Aged, 80 and over ,business.industry ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,digestive system diseases ,Pancreatic Neoplasms ,030104 developmental biology ,ROC Curve ,Spain ,030220 oncology & carcinogenesis ,Cohort ,Female ,CA19-9 ,business - Abstract
CA19-9 serum has been suggested as a marker of unresectability but different cut-off levels have been published. A cut-off of 500 U/ml is currently considered in an international consensus as biological criteria of borderline resectable pancreatic adenocarcinoma. To evaluate whether serum CA19-9 threshold of 500 U/ml could be adequate predictor of resectability in pancreatic adenocarcinoma. Multicenter, observational, prospective study performed in Spain including 203 patients diagnosed with pancreatic adenocarcinoma. 43 (21.2%) cases were resectable and 160 (78.8%) unresectable. Among the 176 preoperative CA19-9 available values, 98 (58.3%) were ≤ 500 U/ml and 73 (42.7%) > 500 U/ml. Resectability rate in those patients with CA19-9 ≤ 500 U/ml was 60% while it was found to be 18% when CA19-9 > 500 U/ml. Statistical model to predict resectability based on CA19-9 provide an AUC of 0.6618 (95% CI 0.53–0.83) when only CA19-9 values > 500 U/ml are studied. Serum levels of CA19-9 higher than 500 U/ml are indicative of unresectable disease, however reduced sensitivity and specificity lead to a limited clinical applicability for resectability.
- Published
- 2020