Serum CA 19‐9 in the postsurgical follow‐up of patients with pancreatic cancer

Abstract

In the last few years serum CA 19‐9 has been shown to be a highly sensitive marker of pancreatic adenocarcinoma. This study assesses the value of serum CA 19‐9 assay in the postsurgical follow‐up of patients undergoing pancreatic cancer resection. In 14 patients with cancer in the head of the pancreas and abnormal preoperative serum CA 19‐9 values (>40 U/ml), a pancreatoduodenectomy was performed. In all patients the CA 19‐9 antigen was immunohistochemically demonstrated on the removed tumoral tissue. Postoperative serum CA 19‐9 concentrations were serially measured 15 days after surgery and then every other month. Serum CA 19‐9 scores returned to the normal range only in 7 (50%) of the resected patients. All patients with a normal postoperative value and none of those with a persistently elevated one survived longer than 7 months. Early postoperative serum CA 19‐9 assay was superior to perioperative staging of the tumor as a prognostic index. All of the seven patients with postoperative normal values exhibited a subsequent increase within 16 months. In all cases the elevation of CA 19‐9 occurred at least 2 months before ultrasound (US) could detect local recurrences of hepatic metastasis. Our data indicate that a normal early postoperative CA 19‐9 score is a relatively favourable prognostic index in patients who undergo radical surgery for pancreatic cancer and that the CA 19‐9 test can be used, as an early marker of recurrence, in monitoring these patients. Copyright © 1987 American Cancer Society