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• W4382799080 abstract "Surgery represents the only potentially curative therapeutic option for patients (pts) with pancreatic cancer, but it is burdened by a high rate of both local and systemic relapse, even with the use of adjuvant chemotherapy. Biomarkers for predicting cancer recurrence are still lacking. Carbohydrate antigen 19-9 (Ca19.9) currently represents the only commonly used marker, but there is limited evidence for the role of its kinetics during follow-up. We retrospectively enrolled pts who carried out follow-up assessment after pancreatic surgery with radical intent at our center between 2015 and 2020. Patients and tumor characteristics and serum CA19.9 values were collected during the follow-up period. We analyzed the six-months CA19.9 velocity, defined as units of increase per milliliter every 3 months (U/mL/3 months). Aim of the study was to correlate six-months CA19.9 velocity with Relapse-Free Survival (RFS), one-year RFS and two-years RFS. Of 226 enrolled patients, 115 were female and 111 were male; median age was 67 (range 44-89) years old. Most of the tumors involved the head (72%), whereas 28% body-tail. At pre surgery evaluation, pts with borderline resectable disease on CT scan were 36%, whereas in 64% there was no vascular involvement (VI). Pathological lymph node status (pN) was pN1 in 49%, pN2 in 27% of pts and pN0 in 24%. Resection margin status was positive in 37% and negative in 63%. Poorly-differentiated cancers represented 25% of cases, moderately differentiated were 44% of cases, and for the remaining cases grading was unknown. Median post-surgery CA19.9 level was 18,80 (0.60-36,474) U/mL. Adjuvant chemotherapy was performed in 66% of pts. At a median follow-up of 65 months, median overall-survival was 36 (2-98) months and median RFS was 15.9 (0-94,8) months. One-year RFS was 60% and two-year RFS was 40%. The correlation coefficient between six-months CA19.9 velocity in relapsed patients and RFS was r -0,2922 (P=0,0001). High six-months CA19.9 velocity, defined as >1 U/mL/3 months, predicted one-year RFS (Chi-squared 6,052; contingency coefficient 0,186; P=0,0139) and two-year RFS (Chi-squared 12,532; contingency coefficient 0,263; P=0,0004). Positive six-months CA19.9 velocity was a prognostic factor at univariate analysis, as Eastern Cooperative Oncology Group performance status (ECOG PS), tumor grading, adjuvant chemotherapy, post-surgery CA19.19 higher than 40 U/mL, pN, VI and positive margin (p < 0.05). At a multivariate analysis, six-months CA19.9 velocity confirmed its independent prognostic role for RFS (HR 1.51 95% CI 1.01-2.25, p=0.04). Post-surgery CA19.19 higher than 40 U/mL (HR 2,40 CI 1,6049 to 3,6088, p < 0.0001), adjuvant chemotherapy (HR 0.43 CI 0.2483 to 0.7511, p < 0.002), pN (HR 1.69 CI 1.2316 to 2.3256, p=0.001) and VI (HR 1.75 CI 1.727 to 2.627, p=0.006) remained as prognostic factors at multivariate analysis. Positive six-months CA19.9 velocity predicts radiographic recurrence with median time of 3,4 (range 0-22.6) months in pts whose recurrence occurs within the first 2 years. Six-months CA19.9 velocity is a promising tool for predicting microscopic residual disease despite adjuvant chemotherapy, and its increase is able to predict in advance radiologic progressive disease." @default.
• W4382799080 created "2023-07-02" @default.
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• W4382799080 date "2023-06-01" @default.
• W4382799080 modified "2023-10-14" @default.
• W4382799080 title "P-402 Six-months CA19.9 velocity as a predictive factor for relapse-free survival after curative pancreasectomy in pancreatic cancer" @default.
• W4382799080 doi "https://doi.org/10.1016/j.annonc.2023.04.458" @default.
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