Published in:
01-06-2011 | Hepatobiliary Tumors
Preoperative Serum CA 19-9 Level as a Predictive Factor for Recurrence after Curative Resection in Biliary Tract Cancer
Authors:
Moon Jae Chung, MD, Kyong Joo Lee, MD, Seungmin Bang, MD, Seung Woo Park, MD, Kyung Sik Kim, MD, Woo Jung Lee, MD, Si Young Song, MD, Jae Bock Chung, MD, Jeong Youp Park, MD
Published in:
Annals of Surgical Oncology
|
Issue 6/2011
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Abstract
Background
Complete surgical removal of biliary tract cancer (BTC) offers the only chance of cure; however, long-term survival remains very limited because of frequent recurrence after surgery. The purpose of our study was to evaluate whether the preoperative serum carbohydrate antigen (CA) 19-9 level could predict recurrence after curative resection of BTC.
Methods
We performed a retrospective review of the medical records of patients who were diagnosed with BTC and underwent curative resection. The optimal cutoff value for the preoperative serum level of CA 19-9 that predicted recurrence was determined by a ROC curve. Preoperative and postoperative risk factors for recurrence were evaluated using log-rank test.
Results
A total of 101 patients were eligible for this study. The optimal cutoff value of preoperative serum CA 19-9 level to predict recurrence was 55 U/mL. Forty-five patients (44.6%) experienced recurrence after curative resection with a median follow-up period of 28.4 months. Recurrence occurred in 33 (61.1%) of 54 patients with CA 19-9 levels ≥55 U/mL compared with only 12 (25.5%) of 47 patients with CA 19-9 levels <55 U/mL. The recurrence rate was significantly higher in patients with baseline CA 19-9 serum levels ≥55 U/mL (hazard ratio, 3.282; 95% confidence interval, 1.684–6.395; P < 0.001).
Conclusions
Elevated preoperative serum CA 19-9 was associated with a high risk of recurrence after curative resection of BTC. Different treatment plans might be needed for patients with BTC and high serum levels of CA 19-9.