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Published in: Annals of Surgical Oncology 3/2021

01-03-2021 | Cancer Biomarker | Pancreatic Tumors

Prognostic Value of the Preoperative Tumor Marker Index in Resected Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Institution Study

Authors: Tatsunori Miyata, MD, PhD, Hiromitsu Hayashi, MD, PhD, Yo-ichi Yamashita, MD, PhD, Kazuki Matsumura, MD, Yosuke Nakao, MD, Rumi Itoyama, MD, Takanobu Yamao, MD, PhD, Masayo Tsukamoto, MD, PhD, Hirohisa Okabe, MD, PhD, Katsunori Imai, MD, PhD, Akira Chikamoto, MD, PhD, Takatoshi Ishiko, MD, PhD, Hideo Baba, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 3/2021

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Abstract

Background

The prediction of prognostic outcomes can provide the most suitable strategy for patients with pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate the clinical value of the preoperative tumor marker index (pre-TI) in predicting prognostic outcomes after resection for PDAC.

Methods

For 183 patients who underwent pancreatic resection of PDAC, adjusted carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), pancreatic cancer-associated antigen-2 (DUpan-2), and s-pancreas-1 antigen (SPan-1) were retrospectively evaluated, and the positive number of these markers was scored as the pre-TI.

Results

A high pre-TI (≥ 2) was significantly associated with a larger tumor and lymph node metastases, and the patients with a high pre-TI had worse prognostic outcomes in terms of both relapse-free survival (RFS) (P < 0.0001, log-rank) and overall survival (OS) (P < 0.0001, Λlog-rank) than the patients with a low pre-TI. The pre-TI was one of the independent factors of a poor prognosis for RFS (hazard ratio [HR], 2.36; P < 0.0001) and OS (HR, 2.27; P < 0.0001). In addition, even for the patients with normal adjusted CA19-9 values (n = 74, 40.4%), those with the high pre-TI had a significantly poorer prognosis than those with a low pre-TI (RFS: P = 0.002, log-rank; OS: P = 0.031, log-rank).

Conclusions

The pre-TI could be a potent predictive marker of prognostic outcomes for patients with resections for PDAC. Patients with a high pre-TI may need additional strategies to improve their prognosis.
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Metadata
Title
Prognostic Value of the Preoperative Tumor Marker Index in Resected Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Institution Study
Authors
Tatsunori Miyata, MD, PhD
Hiromitsu Hayashi, MD, PhD
Yo-ichi Yamashita, MD, PhD
Kazuki Matsumura, MD
Yosuke Nakao, MD
Rumi Itoyama, MD
Takanobu Yamao, MD, PhD
Masayo Tsukamoto, MD, PhD
Hirohisa Okabe, MD, PhD
Katsunori Imai, MD, PhD
Akira Chikamoto, MD, PhD
Takatoshi Ishiko, MD, PhD
Hideo Baba, MD, PhD, FACS
Publication date
01-03-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09022-3

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