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CA 19-9 is an index of response to neoadjunctive chemoradiation therapy in pancreatic cancer.

Publication ,  Journal Article
Willett, CG; Daly, WJ; Warshaw, AL
Published in: Am J Surg
October 1996

PURPOSE: This study examines the changes of serum levels of CA 19-9 in patients with pancreatic cancer following neoadjuvant irradiation and chemotherapy to define the potential role of this tumor marker in preoperative management of these patients. MATERIALS AND METHODS: Serum CA 19-9 levels were measured in 42 patients before receiving external beam irradiation with concurrent 5-fluorouracil in preparation for laparotomy and Whipple procedure or intraoperative irradiation (IORT). The CA 19-9 levels were determined again after irradiation, and changes were correlated with findings of restaging computed tomography (CT) scan and laparotomy. RESULTS: Following preoperative irradiation, 10 patients (24%) experienced an increase in CA 19-9 levels whereas 29 patients (69%) showed a decrease in CA 19-9. There was no change in the CA 19-9 levels of 3 patients (7%) after treatment. Of the 10 patients with increased CA 19-9 levels after irradiation, 9 (90%) had developed distant metastases or local tumor progression as determined by restaging CT scan or at laparotomy. In contrast, only 6 of 29 patients (21%) with declining CA 19-9 levels after irradiation demonstrated metastases or local tumor progression on restaging CT scan or at laparotomy. The correlation of CA 19-9 increase or decrease with disease progression or control, respectively, was statistically significant (P = 0.009). CONCLUSIONS: Serum CA 19-9 levels may rise or fall during neoadjuvant therapy. A rising CA 19-9 reliably indicates cancer progression while a falling CA 19-9 connotes disease control in the majority of patients. In developing strategies for application of neoadjuvant therapy for pancreatic cancer, monitoring of CA 19-9 appears most useful for the identification of patients who manifest progressive tumor growth and metastasis in spite of this treatment.

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Published In

Am J Surg

DOI

ISSN

0002-9610

Publication Date

October 1996

Volume

172

Issue

4

Start / End Page

350 / 352

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Radiotherapy Dosage
  • Peritoneal Neoplasms
  • Pancreatic Neoplasms
  • Middle Aged
  • Male
  • Laparotomy
  • Humans
  • Fluorouracil
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Willett, C. G., Daly, W. J., & Warshaw, A. L. (1996). CA 19-9 is an index of response to neoadjunctive chemoradiation therapy in pancreatic cancer. Am J Surg, 172(4), 350–352. https://doi.org/10.1016/S0002-9610(97)89547-5
Willett, C. G., W. J. Daly, and A. L. Warshaw. “CA 19-9 is an index of response to neoadjunctive chemoradiation therapy in pancreatic cancer.Am J Surg 172, no. 4 (October 1996): 350–52. https://doi.org/10.1016/S0002-9610(97)89547-5.
Willett CG, Daly WJ, Warshaw AL. CA 19-9 is an index of response to neoadjunctive chemoradiation therapy in pancreatic cancer. Am J Surg. 1996 Oct;172(4):350–2.
Willett, C. G., et al. “CA 19-9 is an index of response to neoadjunctive chemoradiation therapy in pancreatic cancer.Am J Surg, vol. 172, no. 4, Oct. 1996, pp. 350–52. Pubmed, doi:10.1016/S0002-9610(97)89547-5.
Willett CG, Daly WJ, Warshaw AL. CA 19-9 is an index of response to neoadjunctive chemoradiation therapy in pancreatic cancer. Am J Surg. 1996 Oct;172(4):350–352.
Journal cover image

Published In

Am J Surg

DOI

ISSN

0002-9610

Publication Date

October 1996

Volume

172

Issue

4

Start / End Page

350 / 352

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Radiotherapy Dosage
  • Peritoneal Neoplasms
  • Pancreatic Neoplasms
  • Middle Aged
  • Male
  • Laparotomy
  • Humans
  • Fluorouracil