Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer
Background: The association between optimal carbohydrate antigen (CA) 19-9 concentration after neoadjuvant chemotherapy (NACT) and prognosis has not been confirmed in patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC). Methods: This retrospective study included...
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MDPI AG
2020-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/5/1477 |
| _version_ | 1797567988077953024 |
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| author | Woohyung Lee Yejong Park Jae Woo Kwon Eunsung Jun Ki Byung Song Jae Hoon Lee Dae Wook Hwang Changhoon Yoo Kyu-pyo Kim Jae Ho Jeong Heung-Moon Chang Baek-Yeol Ryoo Seo Young Park Song Cheol Kim |
| author_facet | Woohyung Lee Yejong Park Jae Woo Kwon Eunsung Jun Ki Byung Song Jae Hoon Lee Dae Wook Hwang Changhoon Yoo Kyu-pyo Kim Jae Ho Jeong Heung-Moon Chang Baek-Yeol Ryoo Seo Young Park Song Cheol Kim |
| author_sort | Woohyung Lee |
| collection | DOAJ |
| description | Background: The association between optimal carbohydrate antigen (CA) 19-9 concentration after neoadjuvant chemotherapy (NACT) and prognosis has not been confirmed in patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC). Methods: This retrospective study included 122 patients with BRPC and 103 with LAPC who underwent surgery after NACT between 2012 and 2019 in a tertiary referral center. Prognostic models were established based on relative difference of the CA 19-9 (RDC), with their prognostic performance compared using C-index and Akaike information criterion (AIC). Results: CA 19-9 concentrations of 37–1000 U/mL before NACT showed prognostic significance in patients with BRPC and LAPC (hazard ratio [HR]: 0.262; 95% confidence interval [CI]: 0.092–0.748; <i>p</i> = 0.012). Prognostic models in this subgroup showed that RDC was independently prognostic of better overall survival (HR: 0.262; 95% CI: 0.093–0.739; <i>p</i> = 0.011) and recurrence free survival (HR: 0.299; 95% CI: 0.140–0.642; <i>p</i> = 0.002). The prognostic performances of RDC (C-index: 0.653; AIC: 227.243), normalization of CA 19-9 after NACT (C-index: 0.625; AIC: 230.897) and surgery (C-index: 0.613; AIC: 233.114) showed no significant differences. Conclusion: RDC was independently associated with better prognosis after NACT in patients with BRPC or LAPC. Decreased CA19-9 after NACT was a prognostic indicator of better survival and recurrence, as was normalization of CA 19-9 after both NACT and surgery. |
| first_indexed | 2024-03-10T19:49:59Z |
| format | Article |
| id | doaj.art-ca924b5982d541078b930bf8a1609b24 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:49:59Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ca924b5982d541078b930bf8a1609b242023-11-20T00:29:55ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195147710.3390/jcm9051477Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic CancerWoohyung Lee0Yejong Park1Jae Woo Kwon2Eunsung Jun3Ki Byung Song4Jae Hoon Lee5Dae Wook Hwang6Changhoon Yoo7Kyu-pyo Kim8Jae Ho Jeong9Heung-Moon Chang10Baek-Yeol Ryoo11Seo Young Park12Song Cheol Kim13Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDepartment of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, KoreaBackground: The association between optimal carbohydrate antigen (CA) 19-9 concentration after neoadjuvant chemotherapy (NACT) and prognosis has not been confirmed in patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC). Methods: This retrospective study included 122 patients with BRPC and 103 with LAPC who underwent surgery after NACT between 2012 and 2019 in a tertiary referral center. Prognostic models were established based on relative difference of the CA 19-9 (RDC), with their prognostic performance compared using C-index and Akaike information criterion (AIC). Results: CA 19-9 concentrations of 37–1000 U/mL before NACT showed prognostic significance in patients with BRPC and LAPC (hazard ratio [HR]: 0.262; 95% confidence interval [CI]: 0.092–0.748; <i>p</i> = 0.012). Prognostic models in this subgroup showed that RDC was independently prognostic of better overall survival (HR: 0.262; 95% CI: 0.093–0.739; <i>p</i> = 0.011) and recurrence free survival (HR: 0.299; 95% CI: 0.140–0.642; <i>p</i> = 0.002). The prognostic performances of RDC (C-index: 0.653; AIC: 227.243), normalization of CA 19-9 after NACT (C-index: 0.625; AIC: 230.897) and surgery (C-index: 0.613; AIC: 233.114) showed no significant differences. Conclusion: RDC was independently associated with better prognosis after NACT in patients with BRPC or LAPC. Decreased CA19-9 after NACT was a prognostic indicator of better survival and recurrence, as was normalization of CA 19-9 after both NACT and surgery.https://www.mdpi.com/2077-0383/9/5/1477pancreatic cancerneoadjuvant chemotherapyresponsecarbohydrate antigen 19-9 |
| spellingShingle | Woohyung Lee Yejong Park Jae Woo Kwon Eunsung Jun Ki Byung Song Jae Hoon Lee Dae Wook Hwang Changhoon Yoo Kyu-pyo Kim Jae Ho Jeong Heung-Moon Chang Baek-Yeol Ryoo Seo Young Park Song Cheol Kim Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer Journal of Clinical Medicine pancreatic cancer neoadjuvant chemotherapy response carbohydrate antigen 19-9 |
| title | Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer |
| title_full | Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer |
| title_fullStr | Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer |
| title_full_unstemmed | Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer |
| title_short | Reduced and Normalized Carbohydrate Antigen 19-9 Concentrations after Neoadjuvant Chemotherapy Have Comparable Prognostic Performance in Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer |
| title_sort | reduced and normalized carbohydrate antigen 19 9 concentrations after neoadjuvant chemotherapy have comparable prognostic performance in patients with borderline resectable and locally advanced pancreatic cancer |
| topic | pancreatic cancer neoadjuvant chemotherapy response carbohydrate antigen 19-9 |
| url | https://www.mdpi.com/2077-0383/9/5/1477 |
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