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CA19-9 decrease and survival according to platelet level in patients with advanced pancreatic cancer.

ABSTRACT: BACKGROUND:CA19-9 decrease during treatment has been associated with superior survival of pancreatic cancer in several studies. The evidence to show the correlation of high platelet level with inferior survival is insufficient in pancreatic cancer. It also remains unclear whether the association between CA19-9 decrease and survival was corresponded to different levels of platelet in metastatic pancreatic cancer. METHODS:We measured CA19-9 serum concentration and platelet level at baseline and after the second cycle of chemotherapy for 200 advanced pancreatic cancer patients. A Cox proportional hazards model was used to compute mortality hazard ratios (HRs) for CA19-9 decrease, adjusting for potential confounders, including age, sex, KPS, prediagnosis body mass index, Diabetes Mellitus, tumor location, first-line chemotherapy regimen, and radiotherapy. RESULTS:We found that the association of CA19-9 decrease with superior overall survival was stronger in advanced pancreatic cancer with a low level of platelet (Pinteraction

SUBMITTER: Chen Y

PROVIDER: S-EPMC6716806 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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CA19-9 decrease and survival according to platelet level in patients with advanced pancreatic cancer.

Chen Y Y Wang Y R YR Deng G C GC Dai G H GH

BMC cancer 20190830 1

<h4>Background</h4>CA19-9 decrease during treatment has been associated with superior survival of pancreatic cancer in several studies. The evidence to show the correlation of high platelet level with inferior survival is insufficient in pancreatic cancer. It also remains unclear whether the association between CA19-9 decrease and survival was corresponded to different levels of platelet in metastatic pancreatic cancer.<h4>Methods</h4>We measured CA19-9 serum concentration and platelet level at ...[more]

PMID: 31470818

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Project description:CA19-9 values are regularly measured in patients with pancreatic cancer. Certainly, its potential as a biomarker has been compromised by false negative results in CA19-9 negative patients and false positive results in benign pancreatico-biliary diseases. For detection of PDAC recurrence, however, CA19-9 might play an important role. The aim of this study is to analyze the accuracy of CA19-9 for detecting recurrence of pancreatic cancer. All included patients were treated either at the University Medical Center Goettingen, or at the Department of Interdisciplinary Oncology and Pneumonology, DRK-Kliniken Nordhessen, Kassel. We analyzed data of 93 patients with pancreatic cancer in the training set and 41 in the validation set, both retrospectively. Pre- and postoperative CA19-9 values and results of imaging techniques were compared. We performed ROC-analysis. The association between longitudinally measured CA19-9 values and relapse was studied with a joint model between a random effects model for the longitudinal CA19-9 measurements and a Cox proportional hazards models for the survival data. In the test set (n = 93 patients) the median follow-up time was 644 days (22 months). Overall, 71 patients (76.3%) developed recurrence during follow-up. Patients with CA19-9 values of <10kU/l were considered as CA19-9 negative patients (n = 11) and excluded from further analysis. Among the rest, approximately 60% of the patients showed significantly elevated CA19-9 prior to detection of recurrence by imaging techniques. Recurrence was shown by 2.45 times elevated CA19-9 values with 90% positive predictive value. In the validation set, 2.45 times elevated CA19-9 values showed recurrence with 90% sensitivity and 83,33% specificity, with an area under the curve of 95%. Based on measured CA19-9 values during follow-up care, the joint model estimates in recurrence-free patients the probability of recurrence-free survival. CA19-9 elevation is an early and reliable sign for PDAC recurrence. On the strength of a very high accuracy in CA19-9 positive patients, it should be considered to use CA19-9 for therapy decision even without a correlate of imaging technics. Using the joint model, follow-up care of PDAC patients after curative therapy can be stratified.

Dataset Information

CA19-9 decrease and survival according to platelet level in patients with advanced pancreatic cancer.

Publications

CA19-9 decrease and survival according to platelet level in patients with advanced pancreatic cancer.

Similar Datasets

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