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Pretreatment CA 19-9 level as a prognostic factor in patients with advanced pancreatic cancer treated with gemcitabine

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Summary

Background. Serum levels of CA 19-9 correlate with survival among patients with pancreatic cancer treated with surgery or radiation therapy. In addition, CA 19-9 responses have been shown to predict for a better prognosis among patients with advanced disease treated with chemotherapy. The present study evaluates the predictive role of CA 19-9 pretreatment levels and response among patients treated with gemcitabine.

Methods. We retrospectively identified 28 patients with advanced pancreatic cancer and baseline elevations of CA 19-9 (>37 U/mL) who were treated with single agent gemcitabine. CA 19-9 response was defined as a ≥50% decline at any time after treatment. Survival was estimated with the Kaplan-Meier method, and curves were compared with the log-rank test.

Results. Eleven patients (39%) had a CA 19-9 response. The median survival of responding patients was longer than that of non-responding patients (13.8 vs 8 mo, p=.0272). When pretreatment CA 19-9 levels were analyzed, patients who had CA 19-9 below the median for the entire sample (1212 U/mL) lived significantly longer than patients with a CA 19-9 above the median (14.9 vs 7.4 mo, p=.0013). On multivariable analysis, pretreatment CA 19-9 level was an independent, and stronger predictor of survival (p=.0005) than CA 19-9 response (p=.0497). Other variables were not associated with survival.

Conclusions. CA 19-9 may be a useful adjunct to response evaluation is this setting. In addition to CA 19-9 responses, prechemotherapy levels of this marker seem to have strong prognostic significance.

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Authors and Affiliations

  1. University of São Paulo, São Paulo, Brazil

    Marcel C. Machado & Dalia Wajsbrot

  2. Centro Paulista de Oncologia, Av. Europa 105, 01449-001, São Paulo, Brazil

    Everardo D. Saad, Roberto Abramoff, Paulo M. Hoff, Jacques Tabacof, Artur Katz, Sergio D. Simon & René C. Gansl

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  1. Everardo D. Saad
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  2. Marcel C. Machado
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Correspondence to Everardo D. Saad.

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Saad, E.D., Machado, M.C., Wajsbrot, D. et al. Pretreatment CA 19-9 level as a prognostic factor in patients with advanced pancreatic cancer treated with gemcitabine. Int J Gastrointest Canc 32, 35–41 (2002). https://doi.org/10.1385/IJGC:32:1:35

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