ArticleCancer medicine2026
Preoperative Biomarker Panel With Fibrinogen, FVIII, and CA 19-9 as a Tool for Prognostic Evaluation in Neoadjuvant-Treated Pancreatic Ductal Adenocarcinoma.
Article in Cancer medicine, 2026. 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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Abstract
backgroundPancreatic ductal adenocarcinoma (PDAC) is highly thrombogenic and lethal, with rising incidence. Combining carbohydrate antigen (CA) 19-9, fibrinogen, coagulation factor VIII (FVIII), albumin, and alkaline phosphatase (ALP) as a diagnostic panel improves diagnostics. We evaluated the prognostic value of this panel in neoadjuvant therapy (NAT) and upfront surgery (US) treated patients undergoing radical-intent surgery.
methodsPDAC patients undergoing radical-intent surgery with available preoperative coagulation variables were included (n = 205). Patients with borderline resectable tumors received NAT (n = 76). The diagnostic panel and a modified panel including only fibrinogen, FVIII, and CA 19-9 were assessed preoperatively and evaluated for disease-specific and disease-free survival (DSS and DFS, respectively). Follow-up was for at least two years or until earlier death.
resultsPreoperative fibrinogen was higher in the US-treated PDAC patients (US PDAC) than in the NAT-treated PDAC patients (NAT PDAC) (p < 0.001). Elevated fibrinogen, FVIII, and CA 19-9 predicted poor DSS individually and as a panel among NAT PDAC; a low modified panel score was associated with better DSS than higher panel scores (HR 7.8, 95% CI 1.7-36.1, p = 0.009).
conclusionsPreoperatively elevated fibrinogen and FVIII indicated a worse prognosis among NAT patients, especially when combined with CA 19-9 in a panel, possibly referring to treatment response after NAT. Further studies should assess whether preoperative dampening of coagulation activity would improve survival.
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