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Perioperative CA19-9 Levels Can Predict Stage and Survival in Patients With Resectable Pancreatic Adenocarcinoma

Park-Krankenhaus Leipzig, Leipzig, Germany

To the Editor:

In the June 20, 2006, issue of the Journal of Clinical Oncology, Ferrone et al¹ propose to include the preoperative tumor marker CA19-9 concentration into a treatment decision model.

The authors have shown in their retrospective analysis of patients with serum bilirubin less than 2 mg/dL, that tumor burden correlates with CA19-9 concentrations. However, presentation of data not only as median values, but, for example, together with minimum and maximum values, would have shown the broad range of CA19-9 concentrations in individual patients.^2-4 A low individual CA19-9 concentration in locally advanced or metastatic disease may underestimate tumor stage. Therefore, in the individual patient, the preoperative CA19-9 concentration is of limited value for treatment decision. In contrast, the change of CA19-9 concentration in the individual patient during serial measurements is of prognostic value in the perioperative and the metastatic situation. A falling CA19-9 concentration is associated with a significantly better prognosis.^3,4 On the other side, increase of CA19-9 concentration after resection of the tumor or during chemotherapy correlates with recurrence and progression of the disease, respectively, and is associated with an extremely poor prognosis.⁴

Author's Disclosures of Potential Conflicts of Interest

The author indicated no potential conflicts of interest.

REFERENCES

1. Ferrone CR, Finkelstein DM, Thayer SP, et al: Perioperative CA19-9 levels can predict stage and survival in patients with resectable pancreatic adenocarcinoma. J Clin Oncol 24:2897-2902, 2006[Abstract/Free Full Text]

2. Lundin J, Roberts PJ, Kuusela P, et al: The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer. Br J Cancer 69:515-519, 1994[Medline]

3. Safi F, Schlosser W, Falkenreck S, et al: Prognostic value of CA 19-9 serum course in pancreatic cancer. Hepatogastroenterology 45:253-259, 1998[Medline]

4. Halm U, Schumann T, Schiefke I, et al: Decrease of CA 19-9 during chemotherapy with gemcitabine predicts survival time in patients with advanced pancreatic cancer. Br J Cancer 82:1013-1016, 2000[CrossRef][Medline]

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This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Halm, U. Search for Related Content PubMed PubMed Citation Articles by Halm, U. Social Bookmarking                            What's this?