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Prognostic Impact of the Initial Postoperative CA19-9 Level in Patients with Extrahepatic Bile Duct Cancer.
J Gastrointest Surg. 2016 08; 20(8):1435-43.JG

Abstract

BACKGROUND

The aim of this study was to investigate the prognostic impact of the initial serum postoperative CA19-9 levels in patients with extrahepatic bile duct cancer.

METHODS

Data of a total of 143 patients of extrahepatic bile duct cancer with elevated preoperative serum CA19-9 levels (>37 U/ml) who underwent surgery with curative intent were reviewed retrospectively. The patients were divided into the "Normalization group" and "Non-normalization group" (initial postoperative serum CA19-9 ≤37 and >37 U/ml, respectively), and the clinicopathological factors and survival outcomes in these groups were comparatively analyzed.

RESULTS

The cumulative 5-year overall survival (OS) rate and median survival time (MST) were 39.2 % and 42.9 months, respectively, in the Normalization group and 17.9 % and 24.0 months, respectively, in the Non-normalization group (P < 0.001). Presence of jaundice, a poorer histological differentiation grade (G3-4), lymph node metastasis, and initial postoperative serum CA19-9 level (>37 U/ml) were significant independent predictors of a poor prognosis on multivariate analysis.

CONCLUSION

Non-normalization of the serum CA19-9 level in the initial postoperative phase is a strong predictor of a poor prognosis and is a useful marker to identify patients who would need additional treatments and stricter follow-up.

Authors+Show Affiliations

Division of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. yuikato@ab.auone-net.jp.Division of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.Division of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.Division of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27250990

Citation

Kato, Yuichiro, et al. "Prognostic Impact of the Initial Postoperative CA19-9 Level in Patients With Extrahepatic Bile Duct Cancer." Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, vol. 20, no. 8, 2016, pp. 1435-43.
Kato Y, Takahashi S, Gotohda N, et al. Prognostic Impact of the Initial Postoperative CA19-9 Level in Patients with Extrahepatic Bile Duct Cancer. J Gastrointest Surg. 2016;20(8):1435-43.
Kato, Y., Takahashi, S., Gotohda, N., & Konishi, M. (2016). Prognostic Impact of the Initial Postoperative CA19-9 Level in Patients with Extrahepatic Bile Duct Cancer. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, 20(8), 1435-43. https://doi.org/10.1007/s11605-016-3180-5
Kato Y, et al. Prognostic Impact of the Initial Postoperative CA19-9 Level in Patients With Extrahepatic Bile Duct Cancer. J Gastrointest Surg. 2016;20(8):1435-43. PubMed PMID: 27250990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic Impact of the Initial Postoperative CA19-9 Level in Patients with Extrahepatic Bile Duct Cancer. AU - Kato,Yuichiro, AU - Takahashi,Shinichiro, AU - Gotohda,Naoto, AU - Konishi,Masaru, Y1 - 2016/06/01/ PY - 2016/03/08/received PY - 2016/05/26/accepted PY - 2016/6/3/entrez PY - 2016/6/3/pubmed PY - 2017/12/8/medline KW - Bile duct cancer KW - CA19-9 KW - Cholangiocarcinoma KW - Prognosis SP - 1435 EP - 43 JF - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract JO - J Gastrointest Surg VL - 20 IS - 8 N2 - BACKGROUND: The aim of this study was to investigate the prognostic impact of the initial serum postoperative CA19-9 levels in patients with extrahepatic bile duct cancer. METHODS: Data of a total of 143 patients of extrahepatic bile duct cancer with elevated preoperative serum CA19-9 levels (>37 U/ml) who underwent surgery with curative intent were reviewed retrospectively. The patients were divided into the "Normalization group" and "Non-normalization group" (initial postoperative serum CA19-9 ≤37 and >37 U/ml, respectively), and the clinicopathological factors and survival outcomes in these groups were comparatively analyzed. RESULTS: The cumulative 5-year overall survival (OS) rate and median survival time (MST) were 39.2 % and 42.9 months, respectively, in the Normalization group and 17.9 % and 24.0 months, respectively, in the Non-normalization group (P < 0.001). Presence of jaundice, a poorer histological differentiation grade (G3-4), lymph node metastasis, and initial postoperative serum CA19-9 level (>37 U/ml) were significant independent predictors of a poor prognosis on multivariate analysis. CONCLUSION: Non-normalization of the serum CA19-9 level in the initial postoperative phase is a strong predictor of a poor prognosis and is a useful marker to identify patients who would need additional treatments and stricter follow-up. SN - 1873-4626 UR - https://www.unboundmedicine.com/medline/citation/27250990/Prognostic_Impact_of_the_Initial_Postoperative_CA19_9_Level_in_Patients_with_Extrahepatic_Bile_Duct_Cancer_ L2 - https://dx.doi.org/10.1007/s11605-016-3180-5 DB - PRIME DP - Unbound Medicine ER -