Evidence map›Paper›PMID 40586705›Full record

ArticleJournal of surgical oncology2025

Recurrence After Gallbladder Cancer Resection: Prognostic Impact of CA19-9 and CEA Levels at Baseline and During Surveillance.

Diamantis I Tsilimigras, Odysseas P Chatzipanagiotou, Andrea Ruzzenente, Federico Aucejo, Hugo P Marques, Joao Bandovas, Tom Hugh, Nazim Bhimani, Shishir K Maithel, Minoru Kitago and 2 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Diamantis I TsilimigrasDepartment of Surgery, Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.ORCID https://orcid.org/0000-0002-3676-9263
Odysseas P ChatzipanagiotouDepartment of Surgery, Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.
Andrea RuzzenenteDepartment of Surgery, University of Verona, Verona, Italy.
Federico AucejoDigestive Diseases and Surgery Institute, Department of Hepato-pancreato-biliary and Liver Transplant Surgery, Cleveland Clinic Foundation, Cleveland, USA.
Hugo P MarquesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Joao BandovasDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Tom HughDepartment of Surgery, University of Sydney, School of Medicine, Sydney, New South Wales, Australia.
Nazim BhimaniDepartment of Surgery, University of Sydney, School of Medicine, Sydney, New South Wales, Australia.
Shishir K MaithelDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-3591-8925
Minoru KitagoDepartment of Surgery, Keio University, Tokyo, Japan.
Itaru EndoDepartment of Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
Timothy M PawlikDepartment of Surgery, Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA.ORCID https://orcid.org/0000-0002-7994-9870

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

introductionBaseline serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) levels may predict prognosis among patients undergoing resection for gallbladder cancer (GBC), yet the prognostic utility of the combination of the two markers has not been well established. In addition, the prognostic significance of elevated preoperative CA19-9 levels that normalize after GBC resection is currently unknown.

methodsPatients undergoing resection of GBC between 2002 and 2021 were identified using an international, multi-institutional database. The association of preoperative CA19-9 and CEA levels with recurrence-free survival (RFS) following GBC resection was assessed. The negative predictive value (NPV) of normal vs. normalized (high preoperative/low postoperative levels) CA19-9 levels relative to the development of recurrence within 1 year after GBC resection was evaluated.

resultsAmong 194 patients who underwent resection of GBC, median preoperative CA19-9 and CEA levels were 18.8 U/mL (IQR 7.0-88.0) and 2.2 ng/mL (IQR 1.3-3.8), respectively. A total of 92 (47.4%) and 67 (34.5%) patients had elevated CA19-9 (> 20 U/mL) and CEA (> 3 ng/mL) levels before GBC resection, respectively. Individuals with low CA19-9/low CEA had the most favorable 3-year RFS (74.5%) after GBC resection followed by individuals with either high CA19-9 (high CA19-9/low CEA: 41.6%) or high CEA (low CA19-9/high CEA: 60.9%) levels, whereas patients with high CA19-9/high CEA had the worst 3-year RFS (21.5%) following GBC resection (p < 0.001). Patients with normal preoperative CA19-9 levels had better 3-year RFS than patients with high preoperative CA19-9 levels that normalized after resection (74.6% vs. 51.4%, p = 0.03). While the NPV of normal preoperative CA19-9 levels relative to the development of recurrence within 1 year after GBC resection was 94.7%, the NPV of normalized CA19-9 decreased to 70% at 1-year post-resection.

conclusionElevation of both preoperative CA19-9 and CEA levels portended poor prognosis following resection of GBC. Normalization of postoperative CA19-9 levels after GBC resection was still associated with elevated risk of recurrence. While preoperative tumor markers can accurately predict prognosis following resection for GBC, evaluation of traditional tumor markers may not be appropriate markers of occult recurrent disease in the postoperative setting. Better markers are needed to monitor for recurrence following resection of GBC.

Indexed as

Biomarkers, TumorCA-19-9 AntigenCarcinoembryonic AntigenGallbladder NeoplasmsNeoplasm Recurrence, LocalAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateBiomarkers, TumorCA-19-9 AntigenCarcinoembryonic AntigenCA 19‐9CEAgallbladder cancerprognosisrecurrenceresection

Identifiers

PMID40586705
PMCPMC12455547

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.