CA 19-9 Velocity Predicts Disease-Free Survival and Overall Survival After Pancreatectomy of Curative Intent
CA 19-9 Velocity Predicts Disease-Free Survival and Overall Survival After Pancreatectomy of Curative Intent
复制标题
DOI：
10.1007/s11605-008-0696-3
复制
发表时间：
2009-02-01
影响因子：
3.2
通讯作者：
Rosemurgy, Alexander
中科院分区：
文献类型：
--
作者：
Hernandez, Jonathan M.;Cowgill, Sarah M.;Rosemurgy, Alexander
本研究旨在探讨血清CA 19-9水平和CA 19-9速度与腺癌胰腺切除术后无病生存和总生存之间的关系。从1997年到2002年，96例患者行胰腺切除术而不进行辅助化疗，作为一项大型随机前瞻性辅助治疗试验的对照组。切除后，在基线、4周和12周的间隔时间绘制CA 19-9水平。CA - 19-9流速表示4周内CA - 19-9水平的变化率。术后基线CA 19-9水平和CA 19-9速度与无病生存和总生存相关。数据以中位数（平均值+/- SD）表示。无病生存期为7个月（14 +/- 13.7），总生存期为12个月（19 +/- 14.3），其中24例（25%）患者存活41个月（39 +/- 7.8）。基线CA 19-9水平和CA 19-9速度预测无病（p < 0.01）和总生存（p < 0.01）。CA 19-9速度比基线CA 19-9更好地预测总生存（p < 0.001）。疾病进展时CA 19-9速度为131 U/ml/4周（1,684 +/- 4,474.8），而无疾病进展的患者在22个月时为1 U/ml/4周（1 +/- 3.8）（p < 0.001）。CA 19-9速度预测胰腺腺癌切除术后即将发生的疾病进展，并且比基线CA 19-9水平更好地预测总生存。CA 19-9速度是一种可靠且相对便宜的胰腺癌切除术后患者监测手段，在所有临床试验患者以及接受辅助治疗的患者中都应考虑。
This study was undertaken to correlate serum CA 19-9 levels and CA 19-9 velocity with disease-free and overall survival after pancreatectomy for adenocarcinoma.From 1997 to 2002, 96 patients underwent pancreatectomy without adjuvant chemotherapy as the control arm of a large randomized prospective adjuvant therapy trial. After resection, CA 19-9 levels were drawn at baseline, 4 weeks, and 12-week intervals thereafter. CA 19-9 velocity denotes rate of change in CA 19-9 levels over a 4-week period. Postoperative baseline CA 19-9 levels and CA 19-9 velocity were correlated with disease-free and overall survival. Data are presented as median (mean +/- SD).Disease-free survival was 7 months (14 +/- 13.7), and overall survival was 12 months (19 +/- 14.3) with 24 (25%) patients alive at 41 months (39 +/- 7.8). Baseline CA 19-9 levels and CA 19-9 velocity predicted disease-free (p < 0.01) and overall survival (p < 0.01). CA 19-9 velocity was a better predictor of overall survival than baseline CA 19-9 (p < 0.001). CA 19-9 velocity at disease progression was 131 U/ml/4-weeks (1,684 +/- 4,474.8) vs. 1 U/ml/4-weeks (1 +/- 3.8) at 22 months for patients without disease progression (p < 0.001).CA 19-9 velocity predicts imminent disease progression after resection of pancreatic adenocarcinoma and is a better predictor of overall survival than baseline CA 19-9 levels. CA 19-9 velocity is a reliable and relatively inexpensive means of monitoring patients after resection of pancreatic cancer and should be considered in all patients enrolled in clinical trials as well as patients receiving adjuvant therapy.