ArticleAnnals of surgery2023
Prognosis Associated With CA19-9 Response Dynamics and Normalization During Neoadjuvant Therapy in Resected Pancreatic Adenocarcinoma.
Article in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
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44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Impact of R0/R1 Margin Status on Overall Survival in Node-Positive Resected Pancreatic Ductal Adenocarcinoma: Meta-Analysis.Annals of surgical oncology · 2026Pooled it
- REDISCOVER guidelines for borderline-resectable and locally advanced pancreatic cancer: management algorithm, unanswered questions, and future perspectives.Updates in surgery · 2024Guideline
- A phase II clinical trial of albumin-bound paclitaxel, cisplatin, gemcitabine (NABPLAGEM), and paricalcitol as neoadjuvant therapy in pancreatic cancer.The oncologist · 2026Trial
- A Model to Predict Treatment Failure in Patients Undergoing Upfront Surgery for Resectable Colorectal Liver Metastases.Annals of surgical oncology · 2023Trial
- Is robotic surgery meeting nodal benchmarks? AJCC and NCCN-based evaluation of lymph node yield and survival in robotic transhiatal esophagectomy.Surgical endoscopy · 2026Article
- Redefining biologically borderline resectable pancreatic cancer: a data-driven reassessment of CA19-9 cutoff and a preoperative lymph node metastasis prediction model.Surgery today · 2026Article
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- Computed tomography quantitative imaging features for pancreatic ductal adenocarcinoma after neoadjuvant therapy: a narrative review.Gland surgery · 2026Review
- Updates on Imaging Assessment of Pancreatic Cancer for Determining Anatomic and Biologic Resectability.Korean journal of radiology · 2026Review
- Restaging after neoadjuvant FOLFIRINOX for localized pancreatic cancer: a clinical calculator from the Trans-Atlantic Pancreatic Surgery consortium.Journal of the National Cancer Institute · 2026Article
- Clinical Significance of an R1 Resection for Pancreatic Ductal Adenocarcinomas Treated by Intensive FOLFIRINOX Induction-Based Chemotherapy and Extended Pancreatectomies.Annals of surgical oncology · 2026Article
- KRAS Mutation Allele Frequency Dynamics in Plasma Extracellular Vesicles: Association with Survival in Localized Pancreatic Adenocarcinoma.Annals of surgical oncology · 2026Article
- Development and validation of a machine learning model for predicting early death in metastatic pancreatic ductal adenocarcinoma: a study based on the SEER database.Translational cancer research · 2026Article
- From metabolic syndrome to survival: a prognostic model for PDAC incorporating insulin resistance markers and pathological variables.Frontiers in endocrinology · 2026Article
- Dynamic perioperative CA19-9 and inflammatory-nutritional recovery patterns are associated with early recurrence and survival after resection for pancreatic ductal adenocarcinoma: a real-world cohort study.Frontiers in medicine · 2026Article
- Prognostic value of perioperative gamma-glutamyl transferase trajectories in perihilar cholangiocarcinoma: a multicentre retrospective cohort study.Therapeutic advances in medical oncology · 2026Article
- Surgery based on resectability status of pancreatic cancer: a narrative review.Japanese journal of clinical oncology · 2025Review
- Evaluating Tumor Regression and Survival Outcomes in Pancreatic Ductal Adenocarcinoma After Neoadjuvant Treatment according to CAP Grading System: Clinical Usefulness and Limitations.Annals of surgical oncology · 2025Article
- Computational pathology approach for assessment of prognosis and immunotherapy response in pan-gastrointestinal cancer.Journal of translational medicine · 2025Article
- Favorable Response Defined by CA19-9 Reduction After Neoadjuvant Treatment for Pancreatic Cancer.Annals of surgical oncology · 2025Article
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Authors and funding
17 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo characterize associations between carbohydrate antigen 19-9 (CA19-9) dynamics during neoadjuvant therapy (NT) and survival for patients with pancreatic ductal adenocarcinoma (PDAC).
backgroundAlthough normalization of CA19-9 during NT is associated with improved outcomes following PDAC resection, we hypothesize that CA19-9 dynamics during NT can improve prognostication.
methodsCharacteristics for patients with PDAC undergoing NT (July 2011-October 2018) with ≥3 CA19-9 results (bilirubin<2mg/dL) were collected and grouped by CA19-9 dynamics. Nonproducers (<1 U/ml) were excluded, and normal was ≤35 U/ml. Postresection survival was compared among groups.
resultsOf 431 patients, 166 had eligible CA19-9 values. Median baseline CA19-9 was 98 U/ml. Overall 2-year postresection recurrence-free survival (RFS) and overall survival (OS) were 37% and 63%, respectively. Patients with normalization (53%) had improved 2-year RFS (47% vs. 28%, P = 0.01) and OS (75% vs. 49%, P = 0.01). CA19-9 dynamics during NT were analyzed by shape, direction, and normalization creating response types ("A-B-C-D-E"). Type A was "Always" decreasing to normalization, B "Bidirectional" with eventual normalization, C "Consistently" normal, D any "Decrease" without normalization, and E "Elevating" without normalization. Types A and B responses were associated with the longest postresection 2-year RFS (51% and 56%) and OS (75% and 92%, respectively) whereas Types D and E had the worst outcomes. After adjusting for node-positivity, perineural invasion, and margin-positivity, CA19-9 response types were independently associated with both RFS and OS, and predicted outcomes are better than CA19-9 normalization alone (likelihood ratio test RFS P < 0.001, OS P = 0.01).
conclusionsThis novel A-B-C-D-E classification of CA19-9 dynamics during NT was associated with postresection outcomes more precisely than CA19-9 normalization alone.
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