Elevated CA 19-9 is associated with worse survival in patients with resected ampullary adenocarcinoma

Artem Boyev; Laura R. Prakash; Yi Ju Chiang; Timothy E. Newhook; Morgan L. Bruno; Elsa M. Arvide; Whitney L. Dewhurst; Michael P. Kim; Naruhiko Ikoma; Jeffrey E. Lee; Rebecca A. Snyder; Ching Wei D. Tzeng; Matthew H.G. Katz; Jessica E. Maxwell

doi:10.1016/j.suronc.2023.101994

Elevated CA 19-9 is associated with worse survival in patients with resected ampullary adenocarcinoma

Artem Boyev, Laura R. Prakash, Yi Ju Chiang, Timothy E. Newhook, Morgan L. Bruno, Elsa M. Arvide, Whitney L. Dewhurst, Michael P. Kim, Naruhiko Ikoma, Jeffrey E. Lee, Rebecca A. Snyder, Ching Wei D. Tzeng, Matthew H.G. Katz, Jessica E. Maxwell

Surgical Oncology

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The prognostic utility of Carbohydrate Antigen 19-9 (CA 19-9) and Carcinoembryonic Antigen (CEA) in ampullary adenocarcinoma is unclear. We sought to evaluate the association between initial tumor marker levels and survival in patients with resected ampullary adenocarcinoma. Methods: This was a single-institution, retrospective cohort study of consecutive patients who underwent pancreatoduodenectomy for ampullary adenocarcinoma from 1999 to 2021. CA 19-9 was assessed after biliary decompression. Contal and O'Quigley method determined optimal biomarker cutoff levels which were correlated with overall survival (OS) using the Kaplan-Meier method and Cox Proportional Hazards Regression. Results: A total of 180 patients underwent pancreatoduodenectomy. Patients with CA 19-9 >100 U/mL had a shorter median OS (28 vs. 132 months, p < 0.001) compared to patients with CA 19-9 ≤ 100 U/mL at diagnosis. Survival was similar between pancreaticobiliary and intestinal tumor subtypes when CA 19-9 was >100 U/mL (OS:25 vs. 33 months, p = 0.415). By Cox regression analysis, CA 19-9 >100 U/mL was independently associated with worse OS (HR 2.8, p = 0.001). Conclusions: Preoperative CA 19-9 >100 U/mL was associated with shorter OS in patients with resected ampullary adenocarcinoma. CA 19–9 may be useful when counseling patients about prognosis or when considering the role of perioperative systemic therapy.

Original language	English (US)
Article number	101994
Journal	Surgical Oncology
Volume	51
DOIs	https://doi.org/10.1016/j.suronc.2023.101994
State	Published - Dec 2023

Keywords

Ampulla of vater
Carbohydrate antigen 19-9
Carcinoembryonic antigen
Carcinoma
Pancreatoduodenectomy
peri-ampullary

ASJC Scopus subject areas

Surgery
Oncology

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10.1016/j.suronc.2023.101994

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Boyev, A., Prakash, L. R., Chiang, Y. J., Newhook, T. E., Bruno, M. L., Arvide, E. M., Dewhurst, W. L., Kim, M. P., Ikoma, N., Lee, J. E., Snyder, R. A., Tzeng, C. W. D., Katz, M. H. G., & Maxwell, J. E. (2023). Elevated CA 19-9 is associated with worse survival in patients with resected ampullary adenocarcinoma. Surgical Oncology, 51, Article 101994. https://doi.org/10.1016/j.suronc.2023.101994

@article{2af2bc95c898473bb6ad34178c387202,

title = "Elevated CA 19-9 is associated with worse survival in patients with resected ampullary adenocarcinoma",

abstract = "Background: The prognostic utility of Carbohydrate Antigen 19-9 (CA 19-9) and Carcinoembryonic Antigen (CEA) in ampullary adenocarcinoma is unclear. We sought to evaluate the association between initial tumor marker levels and survival in patients with resected ampullary adenocarcinoma. Methods: This was a single-institution, retrospective cohort study of consecutive patients who underwent pancreatoduodenectomy for ampullary adenocarcinoma from 1999 to 2021. CA 19-9 was assessed after biliary decompression. Contal and O'Quigley method determined optimal biomarker cutoff levels which were correlated with overall survival (OS) using the Kaplan-Meier method and Cox Proportional Hazards Regression. Results: A total of 180 patients underwent pancreatoduodenectomy. Patients with CA 19-9 >100 U/mL had a shorter median OS (28 vs. 132 months, p < 0.001) compared to patients with CA 19-9 ≤ 100 U/mL at diagnosis. Survival was similar between pancreaticobiliary and intestinal tumor subtypes when CA 19-9 was >100 U/mL (OS:25 vs. 33 months, p = 0.415). By Cox regression analysis, CA 19-9 >100 U/mL was independently associated with worse OS (HR 2.8, p = 0.001). Conclusions: Preoperative CA 19-9 >100 U/mL was associated with shorter OS in patients with resected ampullary adenocarcinoma. CA 19–9 may be useful when counseling patients about prognosis or when considering the role of perioperative systemic therapy.",

keywords = "Ampulla of vater, Carbohydrate antigen 19-9, Carcinoembryonic antigen, Carcinoma, Pancreatoduodenectomy, peri-ampullary",

author = "Artem Boyev and Prakash, {Laura R.} and Chiang, {Yi Ju} and Newhook, {Timothy E.} and Bruno, {Morgan L.} and Arvide, {Elsa M.} and Dewhurst, {Whitney L.} and Kim, {Michael P.} and Naruhiko Ikoma and Lee, {Jeffrey E.} and Snyder, {Rebecca A.} and Tzeng, {Ching Wei D.} and Katz, {Matthew H.G.} and Maxwell, {Jessica E.}",

note = "Publisher Copyright: {\textcopyright} 2023",

year = "2023",

month = dec,

doi = "10.1016/j.suronc.2023.101994",

language = "English (US)",

volume = "51",

journal = "Surgical Oncology",

issn = "0960-7404",

publisher = "Elsevier BV",

}

TY - JOUR

T1 - Elevated CA 19-9 is associated with worse survival in patients with resected ampullary adenocarcinoma

AU - Boyev, Artem

AU - Prakash, Laura R.

AU - Chiang, Yi Ju

AU - Newhook, Timothy E.

AU - Bruno, Morgan L.

AU - Arvide, Elsa M.

AU - Dewhurst, Whitney L.

AU - Kim, Michael P.

AU - Ikoma, Naruhiko

AU - Lee, Jeffrey E.

AU - Snyder, Rebecca A.

AU - Tzeng, Ching Wei D.

AU - Katz, Matthew H.G.

AU - Maxwell, Jessica E.

PY - 2023/12

Y1 - 2023/12

N2 - Background: The prognostic utility of Carbohydrate Antigen 19-9 (CA 19-9) and Carcinoembryonic Antigen (CEA) in ampullary adenocarcinoma is unclear. We sought to evaluate the association between initial tumor marker levels and survival in patients with resected ampullary adenocarcinoma. Methods: This was a single-institution, retrospective cohort study of consecutive patients who underwent pancreatoduodenectomy for ampullary adenocarcinoma from 1999 to 2021. CA 19-9 was assessed after biliary decompression. Contal and O'Quigley method determined optimal biomarker cutoff levels which were correlated with overall survival (OS) using the Kaplan-Meier method and Cox Proportional Hazards Regression. Results: A total of 180 patients underwent pancreatoduodenectomy. Patients with CA 19-9 >100 U/mL had a shorter median OS (28 vs. 132 months, p < 0.001) compared to patients with CA 19-9 ≤ 100 U/mL at diagnosis. Survival was similar between pancreaticobiliary and intestinal tumor subtypes when CA 19-9 was >100 U/mL (OS:25 vs. 33 months, p = 0.415). By Cox regression analysis, CA 19-9 >100 U/mL was independently associated with worse OS (HR 2.8, p = 0.001). Conclusions: Preoperative CA 19-9 >100 U/mL was associated with shorter OS in patients with resected ampullary adenocarcinoma. CA 19–9 may be useful when counseling patients about prognosis or when considering the role of perioperative systemic therapy.

AB - Background: The prognostic utility of Carbohydrate Antigen 19-9 (CA 19-9) and Carcinoembryonic Antigen (CEA) in ampullary adenocarcinoma is unclear. We sought to evaluate the association between initial tumor marker levels and survival in patients with resected ampullary adenocarcinoma. Methods: This was a single-institution, retrospective cohort study of consecutive patients who underwent pancreatoduodenectomy for ampullary adenocarcinoma from 1999 to 2021. CA 19-9 was assessed after biliary decompression. Contal and O'Quigley method determined optimal biomarker cutoff levels which were correlated with overall survival (OS) using the Kaplan-Meier method and Cox Proportional Hazards Regression. Results: A total of 180 patients underwent pancreatoduodenectomy. Patients with CA 19-9 >100 U/mL had a shorter median OS (28 vs. 132 months, p < 0.001) compared to patients with CA 19-9 ≤ 100 U/mL at diagnosis. Survival was similar between pancreaticobiliary and intestinal tumor subtypes when CA 19-9 was >100 U/mL (OS:25 vs. 33 months, p = 0.415). By Cox regression analysis, CA 19-9 >100 U/mL was independently associated with worse OS (HR 2.8, p = 0.001). Conclusions: Preoperative CA 19-9 >100 U/mL was associated with shorter OS in patients with resected ampullary adenocarcinoma. CA 19–9 may be useful when counseling patients about prognosis or when considering the role of perioperative systemic therapy.

KW - Ampulla of vater

KW - Carbohydrate antigen 19-9

KW - Carcinoembryonic antigen

KW - Carcinoma

KW - Pancreatoduodenectomy

KW - peri-ampullary

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UR - http://www.scopus.com/inward/citedby.url?scp=85171635066&partnerID=8YFLogxK

U2 - 10.1016/j.suronc.2023.101994

DO - 10.1016/j.suronc.2023.101994

M3 - Article

C2 - 37742542

AN - SCOPUS:85171635066

SN - 0960-7404

VL - 51

JO - Surgical Oncology

JF - Surgical Oncology

M1 - 101994

ER -

Elevated CA 19-9 is associated with worse survival in patients with resected ampullary adenocarcinoma

Abstract

Keywords

ASJC Scopus subject areas

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