Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective Study
<b>Background</b>: Carbohydrate antigen 19-9 (CA19-9) is used as a marker to predict recurrence and survival of patients with pancreatic ductal adenocarcinoma (PDAC). Recently, fecal elastase-1 (FE-1) has been shown to correlate with prognosis in patients with PDAC. <b>Method</b...
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2024-12-01
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| author | Hyung Sun Kim Woojin Kim Won-Gun Yun Hye-Sol Jung Youngmin Han Mirang Lee Wooil Kwon Jin-Young Jang Joon Seong Park |
| author_facet | Hyung Sun Kim Woojin Kim Won-Gun Yun Hye-Sol Jung Youngmin Han Mirang Lee Wooil Kwon Jin-Young Jang Joon Seong Park |
| author_sort | Hyung Sun Kim |
| collection | DOAJ |
| description | <b>Background</b>: Carbohydrate antigen 19-9 (CA19-9) is used as a marker to predict recurrence and survival of patients with pancreatic ductal adenocarcinoma (PDAC). Recently, fecal elastase-1 (FE-1) has been shown to correlate with prognosis in patients with PDAC. <b>Method</b>: A total of 536 patients who underwent curative intent surgery between 2010 and 2019 were included in the study. The cutoff points of preoperative CA19-9 and FE-1 levels were extracted from the Youden index and previous studies. Cox proportional hazard models were used to investigate the association between preoperative tumor marker levels and survival after surgery. <b>Results</b>: Patients with CA19-9 ≥ 385 had more advanced T-/N-stages and lower survival rates compared to those with CA19-9 < 385. Multivariate Cox analyses demonstrated that combining preoperative tumor markers was associated with worse 3-year overall survival (both CA19-9 and FE-1 low, HR = 1.41, <i>p</i> = 0.044; both high, HR = 1.44, <i>p</i> = 0.047; CA19-9 high and FE-1 low, HR = 2.00, <i>p</i> < 0.001; and <i>p</i> for trend < 0.001). The same trend was confirmed in the analysis with recurrence-free survival. <b>Conclusions:</b> This study presents a new predictive strategy using combined CA19-9 and FE-1 levels to determine the treatment for resectable pancreatic cancer. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-125a141282ce4e38a74869295aabfc032025-01-24T13:23:53ZengMDPI AGBiomedicines2227-90592024-12-011316210.3390/biomedicines13010062Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective StudyHyung Sun Kim0Woojin Kim1Won-Gun Yun2Hye-Sol Jung3Youngmin Han4Mirang Lee5Wooil Kwon6Jin-Young Jang7Joon Seong Park8Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of KoreaDepartment of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of KoreaDepartment of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of KoreaDepartment of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of KoreaDepartment of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of KoreaDepartment of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of KoreaDepartment of Surgery and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea<b>Background</b>: Carbohydrate antigen 19-9 (CA19-9) is used as a marker to predict recurrence and survival of patients with pancreatic ductal adenocarcinoma (PDAC). Recently, fecal elastase-1 (FE-1) has been shown to correlate with prognosis in patients with PDAC. <b>Method</b>: A total of 536 patients who underwent curative intent surgery between 2010 and 2019 were included in the study. The cutoff points of preoperative CA19-9 and FE-1 levels were extracted from the Youden index and previous studies. Cox proportional hazard models were used to investigate the association between preoperative tumor marker levels and survival after surgery. <b>Results</b>: Patients with CA19-9 ≥ 385 had more advanced T-/N-stages and lower survival rates compared to those with CA19-9 < 385. Multivariate Cox analyses demonstrated that combining preoperative tumor markers was associated with worse 3-year overall survival (both CA19-9 and FE-1 low, HR = 1.41, <i>p</i> = 0.044; both high, HR = 1.44, <i>p</i> = 0.047; CA19-9 high and FE-1 low, HR = 2.00, <i>p</i> < 0.001; and <i>p</i> for trend < 0.001). The same trend was confirmed in the analysis with recurrence-free survival. <b>Conclusions:</b> This study presents a new predictive strategy using combined CA19-9 and FE-1 levels to determine the treatment for resectable pancreatic cancer.https://www.mdpi.com/2227-9059/13/1/62resectable pancreatic cancerCA19-9fecal elastase-1preoperative tumor markercutoff value |
| spellingShingle | Hyung Sun Kim Woojin Kim Won-Gun Yun Hye-Sol Jung Youngmin Han Mirang Lee Wooil Kwon Jin-Young Jang Joon Seong Park Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective Study Biomedicines resectable pancreatic cancer CA19-9 fecal elastase-1 preoperative tumor marker cutoff value |
| title | Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective Study |
| title_full | Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective Study |
| title_fullStr | Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective Study |
| title_full_unstemmed | Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective Study |
| title_short | Novel Predictive Strategy Using CA19-9 and Fecal Elastase Levels to Make Treatment Decisions for Resectable Pancreatic Cancer: A Retrospective Study |
| title_sort | novel predictive strategy using ca19 9 and fecal elastase levels to make treatment decisions for resectable pancreatic cancer a retrospective study |
| topic | resectable pancreatic cancer CA19-9 fecal elastase-1 preoperative tumor marker cutoff value |
| url | https://www.mdpi.com/2227-9059/13/1/62 |
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