Prognostic Impact of Perioperative CA19-9 Levels in Patients with Resected Perihilar Cholangiocarcinoma.
- Abstract
- We aimed to examine the predictive value of changes in perioperative carbohydrate antigen (CA) 19-9 levels for patients operated for perihilar cholangiocarcinoma (pCCA). A total of 322 patients who underwent curative resection for pCCA were divided into three groups: normal preoperative CA19-9 (CA19-9 ≤ 37 U/mL), normalization (preoperative CA19-9 > 37 U/mL, postoperative CA19-9 ≤ 37 U/mL), and non-normalization (pre- and postoperative CA19-9 > 37 U/mL) groups. The association of clinicopathological factors with overall survival (OS) was investigated. The non-normalization group (n = 82) demonstrated significantly worse OS than the normal CA19-9 (n = 114) and normalization (n = 126) groups (5-year OS, 16.9%, 29.4%, and 34.4%, respectively; both p ≤ 0.001). The cutoff points of 300 U/mL for preoperative (p = 0.001) and 37 U/mL for postoperative (p < 0.001) CA19-9 levels showed the strongest prognostic values. In the non-normalization group, patients who underwent R1 resection displayed significantly worse OS than those who underwent R0 resection (median OS, 10.2 vs. 15.7 months; p = 0.016). Multivariate analysis revealed that lymph node metastasis (hazard ratio (HR), 2.07; p < 0.001), postoperative CA19-9 > 37 U/mL (HR, 1.94; p < 0.001), transfusion (HR, 1.74; p = 0.002), and T stage (T3,4) (HR, 1.67; p = 0.006) were related to worse OS. Persistent high CA19-9 level after resection of pCCA and R1 resection, especially in the non-normalization group, was associated with poor OS. A high postoperative CA19-9 level was an independent prognostic factor in resected pCCA.
- Author(s)
- 권재우; 김송철; 박예종; 송기병; 이우형; 이재훈; 이종우; 황대욱
- Issued Date
- 2021
- Type
- Article
- Keyword
- CA19-9; perihilar cholangiocarcinoma; prognosis; tumor marker
- DOI
- 10.3390/jcm10071345
- URI
- https://oak.ulsan.ac.kr/handle/2021.oak/8078
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_ea3bb44e550b491986f365de08d6126a&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Prognostic%20Impact%20of%20Perioperative%20CA19-9%20Levels%20in%20Patients%20with%20Resected%20Perihilar%20Cholangiocarcinoma.&offset=0&pcAvailability=true
- Publisher
- Journal of clinical medicine
- Location
- 미국
- Language
- 영어
- ISSN
- 2077-0383
- Citation Volume
- 10
- Citation Number
- 7
- Citation Start Page
- 1345
- Citation End Page
- 1355
-
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- Medicine > Medicine
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