ArticleThe British journal of surgery2023
Predictive value of baseline serum carbohydrate antigen 19-9 level on treatment effect of neoadjuvant chemoradiotherapy in patients with resectable and borderline resectable pancreatic cancer in two randomized trials.
Article in The British journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 12 citations in OpenAlex.
- Quantitative CT Perfusion as a prognostic biomarker for chemotherapy response in patients with pancreatic ductal adenocarcinoma.Abdominal radiology (New York) · 2026Article
- Article
- CA19-9 as a Dynamic Biomarker for Continuous Monitoring of Therapeutic Efficacy in Pancreatic Adenocarcinoma.Cancers · 2025Review
- Resectable Pancreatic Cancer with CA19-9 > 500 U/mL: A Biological Indicator for Survival Benefit with Intensive Neoadjuvant Chemotherapy.Annals of surgical oncology · 2025Article
- Neoadjuvant Stereotactic Ablative Radiotherapy in Pancreatic Ductal Adenocarcinoma: A Review of Perioperative and Long-Term Outcomes.Diseases (Basel, Switzerland) · 2025Review
- Preoperative Prognostic Factors in Resectable Pancreatic Cancer: State of the Art and Prospects.Annals of surgical oncology · 2025Review
- Neoadjuvant mFOLFIRINOX for resectable pancreatic cancer: increasing evidence, ongoing challenges.Translational gastroenterology and hepatology · 2025Article
- Using a CA19-9 Tumor Marker Gene Test to Assess Outcome After Pancreatic Cancer Surgery.Annals of surgical oncology · 2024Article
- Comment on: Predictive value of baseline serum carbohydrate antigen 19-9 level on treatment effect of neoadjuvant chemoradiotherapy in patients with resectable and borderline resectable pancreatic cancer in two randomized trials.The British journal of surgery · 2024Article
- Anatomical and Biological Considerations to Determine Resectability in Pancreatic Cancer.Cancers · 2024Review
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28 authors at 13 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundGuidelines suggest that the serum carbohydrate antigen (CA19-9) level should be used when deciding on neoadjuvant treatment in patients with resectable and borderline resectable pancreatic ductal adenocarcinoma (hereafter referred to as pancreatic cancer). In patients with resectable pancreatic cancer, neoadjuvant therapy is advised when the CA19-9 level is 'markedly elevated'. This study investigated the impact of baseline CA19-9 concentration on the treatment effect of neoadjuvant chemoradiotherapy (CRT) in patients with resectable and borderline resectable pancreatic cancers.
methodsIn this post hoc analysis, data were obtained from two RCTs that compared neoadjuvant CRT with upfront surgery in patients with resectable and borderline resectable pancreatic cancers. The effect of neoadjuvant treatment on overall survival was compared between patients with a serum CA19-9 level above or below 500 units/ml using the interaction test.
resultsOf 296 patients, 179 were eligible for analysis, 90 in the neoadjuvant CRT group and 89 in the upfront surgery group. Neoadjuvant CRT was associated with superior overall survival (HR 0.67, 95 per cent c.i. 0.48 to 0.94; P = 0.019). Among 127 patients (70, 9 per cent) with a low CA19-9 level, median overall survival was 23.5 months with neoadjuvant CRT and 16.3 months with upfront surgery (HR 0.63, 0.42 to 0.93). For 52 patients (29 per cent) with a high CA19-9 level, median overall survival was 15.5 months with neoadjuvant CRT and 12.9 months with upfront surgery (HR 0.82, 0.45 to 1.49). The interaction test for CA19-9 level exceeding 500 units/ml on the treatment effect of neoadjuvant CRT was not significant (P = 0.501).
conclusionBaseline serum CA19-9 level defined as either high or low has prognostic value, but was not associated with the treatment effect of neoadjuvant CRT in patients with resectable and borderline resectable pancreatic cancers, in contrast with current guideline advice.
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