Table 3.
Published studies analyzing the correlation between serum CA 19-9 level and Pancreatic Cancer resectability (1980–2010)
| Author, Year | N= | Tumor status | CA19-9 serum levels (U/ml) | |
|---|---|---|---|---|
| Median | Mean | |||
| Paganuzzi et al. 1988 [29] | 7 | Resectable | NA | 94 ± 59 |
| 19 | Unresectable | 563 ± 768 (p > 0.05) | ||
| Safi et al. 1997 [22] | 106 | Resectable | 152 | NA |
| 199 | Unresectable | 512 | ||
| Nakao et al. 1998 [30] | 18 | Resectable | NA | <1,344 |
| 130 | Unresectable | >2,000 (range 5–32,240) | ||
| Kau et al. 1998 [31] | 19 | Resectable | NA | 524 ± 70 (p < 0.002) |
| 40 | Unresectable | 3,114 ± 1,643 | ||
| Schleiman et al. 2003 [32] | Mean±SD (U/ml) | |||
| 40 | Resectable | 73.5 | 386 ± 1,169 | |
| 49 | Unresectable | 374 | 1,568 ± 2,979 (p < 0.001) | |
| 25 | Locally advanced | 336 | 1,090 ± 1,541 (p < 0.003) | |
| 24 | Metastatic | 431 | 2,066 ± 3,942 (p < 0.01) | |
| Kilic et al. 2004 [33] | 18 | Resectable | 19.3 | 111.98 ± 156.23 (p < 0.034) |
| 15 | Unresectable | 302 | 1,860.14 ± 3,091.43 | |
| 18 | Disseminated | 500 | 3,188.09 ± 4,089.71 (p < 0.004) | |
| 9 | Peritoneal Metastasis | 780.49 | 3,967.94 ± 4,703.70 (p < 0.113) | |
| Fujioka et al. 2007 [34] | Median | |||
| 93 | R0 Resection | 78 | ||
| 66 | R1/2 Resection | 155 | ||
| 85 | Locally advanced/Metastatic | 326 | ||
| Maithel et al. 2008 [35] | 211 | Resectable | 131 | |
| 51 | Unresectable | 379 | ||
| Zhang et al. 2008 [36] | Median | Predictive value | ||
| 54 | Resectable | <353 | 84.38% (+) | |
| 36 | Unresectable | >352 | 90.00% (−) | |
| Kim et al. 2009 [25] | Median | Mean±SD | ||
| 24 | R0 Resection | 49.66 | 111 ± 156.23 (p < 0.0034) | |
| 48 | R1/2 Resection | 233.03 | 1,860 ± 3,091 | |
| 42 | Unresectable | 174.07 | 1,560 ± 2,985 | |
| Kondo et al. 2010 [26] | Median | |||
| 77 | R0 Resection | 118 | ||
| 11 | R1/2 Resection | 203 | ||
Published studies suggest that pre-operative CA 19-9 serum levels are highly correlated to subsequent pancreatic cancer resectability rates. A median CA 19-9 serum level of <100 U/ml correlates with resectability (positive predictive value, PPV of 60–80%) whereas CA19-9 levels higher than >100 U/ml suggested advanced or metastatic disease with a PPV for unresectability of 88–91%.
U/ml unit/milliliter, SD standard deviation, NA not available, R0 resection-microscopic margin tumor free, R1 resection-microscopic margins positive for tumor, R2 resection- macroscopic tumor left behind