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Journal of Gastrointestinal Surgery

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01-08-2008 | original article

Prognosis of Resected Ampullary Adenocarcinoma by Preoperative Serum CA19-9 Levels and Platelet-Lymphocyte Ratio

Authors: Richard A. Smith, Paula Ghaneh, Robert Sutton, Michael Raraty, Fiona Campbell, John P. Neoptolemos

Published in: Journal of Gastrointestinal Surgery | Issue 8/2008

Abstract

Background

The objective of this study was to evaluate whether preoperative CA19-9 levels and the platelet–lymphocyte ratio (PLR) might reflect prognostic indices for resected ampullary adenocarcinoma.

Materials and Methods

Data were collected prospectively over a 10-year period for consecutive patients undergoing pancreatoduodenectomy for malignancy.

Results

Both preoperative PLR and CA19-9 results were available in 52 cases of resected ampullary adenocarcinoma. Preoperative CA19-9 levels of ≤150 kU/l (or ≤300 kU/l in the presence of bilirubin levels >35 µmol/l) and a PLR of ≤160 were found to represent the optimal cut-off values to risk stratify patients. If both levels were elevated (n = 8), patients had a median overall survival of 10.1 months. If either CA19-9 or PLR were elevated individually (n = 23), patients had a median survival of 25.2 months. For cases where both levels were less than the cut-off values (n = 21), the median overall survival time was not reached but was greater than 60 months (log rank, p < 0.001). This preoperative risk stratification was found to remain a significant independent predictor of survival on multivariate analysis (Cox, p = 0.001) alongside resection margin status (p = 0.002) and tumor size (p = 0.051).

Conclusions

Preoperative CA19-9 and PLR both merit further evaluation as prognostic indices in resected ampullary adenocarcinoma.

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Title: Prognosis of Resected Ampullary Adenocarcinoma by Preoperative Serum CA19-9 Levels and Platelet-Lymphocyte Ratio
Authors: Richard A. Smith
Paula Ghaneh
Robert Sutton
Michael Raraty
Fiona Campbell
John P. Neoptolemos
Publication date: 01-08-2008
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 8/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0554-3

At a glance: The STEP trials

Springer Medicine

Prognosis of Resected Ampullary Adenocarcinoma by Preoperative Serum CA19-9 Levels and Platelet-Lymphocyte Ratio

Abstract

Background

Materials and Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and Methods

Results

Conclusions

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