CA 19-9 LEVEL AS INDICATOR OF EARLY DISTANT METASTASIS AND THERAPEUTIC SELECTION IN RESECTED PANCREATIC CANCER

Purpose: In patients with pancreatic cancer treated with curative resection, we evaluated the effect of clinicopathologic parameters on early distant metastasis within 6 months (DM6m) to identify patients who might benefit from surgery. Methods and Materials: The study involved 84 patients with pancreatic cancer who had undergone curative resection between August 2001 and April 2009. The parameters of gender, age, tumor size, histologic differentiation, T classification, N classification, pre- and postoperative carbohydrate antigen (CA) 19-9 level, resection margin, and adjuvant chemoradiotherapy were analyzed to identify the risk factors associated with DM6m. Results: Of the 84 patients, locoregional recurrence developed in 35 (41.7%) and distant metastasis in 58 (69%). Of the 58 patients with distant metastasis, DM6m had developed in 27 (46.6%). Multivariate analysis showed that preoperative CA 19-9 level was significantly associated with DM6m (p < .05). Of all 84 patients, DM6m was observed in 9.1%, 50%, and 80% of those with a preoperative CA 19-9 level of <= 100 U/mL, 101-400 U/mL, and >400 U/mL, respectively (p < .001). Conclusions: The preoperative CA 19-9 level might be a useful predictor of DM6m and to identify those who would benefit from surgical resection. (C) 2011 Elsevier Inc.