ArticleUnited European gastroenterology journal2023
The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program.
Article in United European gastroenterology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Serum CA19.9 for Detecting High-Grade Dysplasia and Invasive Carcinoma in Patients With Intraductal Papillary Mucinous Neoplasm: A Systematic Review and Meta-Analysis.JAMA network open · 2026Pooled it
- Optimal upper gastrointestinal surveillance strategies for gastric, small bowel and pancreatic cancer detection in Lynch syndrome.Familial cancer · 2026Review
- Cystic tumors of the pancreas: Current perspectives on diagnosis and management.World journal of gastroenterology · 2025Review
- Multi-omic profiling of intraductal papillary neoplasms of the pancreas reveals distinct patterns and potential markers of progression.Cancer cell · 2025Article
- The Differential Diagnosis and Management of Pancreatic Cystic Neoplasms.Deutsches Arzteblatt international · 2025Review
- Differentiating Main-Duct IPMN from Chronic Pancreatitis Using Next-Generation Sequencing of Main Pancreatic Duct Fluid: A Pilot Study.Diagnostics (Basel, Switzerland) · 2025Article
- Endoscopic Ultrasound-Guided Pancreatic Cystic Fluid Biochemical and Genetic Analysis for the Differentiation Between Mucinous and Non-Mucinous Pancreatic Cystic Lesions.Journal of clinical medicine · 2025Review
- Pancreatic Cancer: A Review of Risk Factors.Life (Basel, Switzerland) · 2024Review
- Novel Insights into Postoperative Surveillance in Resected Pancreatic Cystic Neoplasms-A Review.Diagnostics (Basel, Switzerland) · 2024Review
- Recent Advances and Future Challenges in Pancreatic Cancer Care: Early Detection, Liquid Biopsies, Precision Medicine and Artificial Intelligence.Journal of clinical medicine · 2023Article
- The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program.United European gastroenterology journal · 2023Article
- Portuguese Pancreatic Club Perspective on Intraductal Papillary Mucinous Neoplasm Diagnosis, Characterization and Indications for Fine-Needle Aspiration/Biopsy, Advanced Endoscopic Ultrasound Imaging Techniques and Role of Pancreatoscopy.GE Portuguese journal of gastroenterologyReview
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Authors and funding
32 authors at 20 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst surveillance population.
methodsThe PACYFIC-registry is a prospective collaboration that investigates the yield of pancreatic cyst surveillance performed at the discretion of the treating physician. We included participants for whom at least one serum CA19.9 value was determined by a minimum follow-up of 12 months.
resultsOf 1865 PACYFIC participants, 685 met the inclusion criteria for this study (mean age 67 years, SD 10; 61% female). During a median follow-up of 25 months (IQR 24, 1966 visits), 29 participants developed high-grade dysplasia (HGD) or pancreatic cancer. At baseline, CA19.9 ranged from 1 to 591 kU/L (median 10 kU/L [IQR 14]), and was elevated (≥37 kU/L) in 64 participants (9%). During 191 of 1966 visits (10%), an elevated CA19.9 was detected, and these visits more often led to an intensified follow-up (42%) than those without an elevated CA19.9 (27%; p < 0.001). An elevated CA19.9 was the sole reason for surgery in five participants with benign disease (10%). The baseline CA19.9 value was (as continuous or dichotomous variable at the 37 kU/L threshold) not independently associated with HGD or pancreatic cancer development, whilst a CA19.9 of ≥ 133 kU/L was (HR 3.8, 95% CI 1.1-13, p = 0.03).
conclusionsIn this pancreatic cyst surveillance cohort, CA19.9 monitoring caused substantial harm by shortening surveillance intervals (and performance of unnecessary surgery). The current CA19.9 cutoff was not predictive of HGD and pancreatic cancer, whereas a higher cutoff may decrease false-positive values. The role of CA19.9 monitoring should be critically appraised prior to implementation in surveillance programs and guidelines.
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