CA 19-9 and survival in advanced and unresectable pancreatic adenocarcinoma and cholangiocarcinoma

J Gastrointest Cancer. 2007;38(2-4):108-14. doi: 10.1007/s12029-008-9019-x.

Abstract

Background: The CA 19-9 tumour marker is increasingly used to monitor response to therapy in patients with pancreatic adenocarcinoma. Serum CA 19-9 levels have also been shown to correlate with survival. However, their role in cholangiocarcinoma is less clear.

Aim of study: To assess the utility of CA 19-9 levels in the management of patients with advanced pancreatic adenocarcinoma or cholangiocarcinoma in routine clinical practice is the aim of the study.

Methods: A retrospective analysis of CA 19-9 values and survival was performed in 26 patients with pancreatic adenocarcinoma receiving gemcitabine and in 18 patients with cholangiocarcinoma.

Results: Patients with advanced pancreatic adenocarcinoma receiving gemcitabine who experienced a decrease of > or = 20% in CA 19-9 concentration had a median survival of 13.9+ months (range 4.2-23.5) compared to 7.6+ months (range 4.0-14.7) in those without such a change (p = 0.0109). In patients with advanced cholangiocarcinoma, the median survival was longest in those with a baseline CA 19-9 level of less than 1,000 U/ml; 11.8 months (range 1.0-41.4) vs 6.2 months (range 3.1-9.4; p = 0.0075).

Conclusions: The CA 19-9 concentration has a valuable role in predicting outcome in patients with pancreatic adenocarcinoma and cholangiocarcinoma. It is helpful in guiding therapy and should be used accordingly in oncology practice.

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / mortality*
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / therapeutic use
  • Bile Duct Neoplasms / blood
  • Bile Duct Neoplasms / drug therapy
  • Bile Duct Neoplasms / mortality*
  • Bile Ducts, Intrahepatic / pathology
  • Biomarkers, Tumor / blood
  • CA-19-9 Antigen / blood*
  • Cholangiocarcinoma / blood
  • Cholangiocarcinoma / drug therapy
  • Cholangiocarcinoma / mortality*
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Female
  • Gemcitabine
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pancreatic Neoplasms / blood
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / mortality*
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Biomarkers, Tumor
  • CA-19-9 Antigen
  • Deoxycytidine
  • Gemcitabine