Table 3. 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%.
| Author, Year | n | Tumor status | CA19-9 serum levels (U/mL) |
||
|---|---|---|---|---|---|
| Median | Mean | ||||
| Paganuzzi et al., 1988 (29) |
7 19 |
Resectable Unresectable |
NA |
94±59 563±768 (P>0.05) |
|
| Safi et al., 1997 (22) |
106 199 |
Resectable Unresectable |
152 512 |
NA |
|
| Nakao et al., 1998 (30) |
18 130 |
Resectable Unresectable |
NA |
<1,344 >2,000 (range 5-32,240) |
|
| Kau et al., 1998 (31) |
19 40 |
Resectable Unresectable |
NA |
524±70 (P=0.002) 3,114±1643 |
|
| Schleiman et al., 2003 (32) |
40 49 25 24 |
Resectable Unresectable Locally advanced Metastatic |
73.5 374 336 431 |
Mean±SD (U/mL) |
|
| 386±1,169 1,568±2,979 (P<0.001) 1,090±1541 (P=0.003) 2,066±3,942 (P<0.01) | |||||
| Kilic et al., 2004 (33) |
18 15 18 9 |
Resectable Unresectable Disseminated Peritoneal Metastasis |
19.3 302 500 780.49 |
111.98±156.23 (P<0.034) 1,860.14±3,091.43 3,188.09±4,089.71 (P<0.004) 3,967.94±4,703.70 (P<0.113) |
|
| Fujioka et al., 2007 (34) |
93 66 85 |
R0 Resection R1/2 Resection Locally advanced /Metastatic |
Median |
||
| 78 155 326 | |||||
| Maithel et al., 2008 (35) |
211 51 |
Resectable Unresectable |
131 379 |
||
| Zhang et al., 2008 (36) |
54 36 |
Resectable Unresectable |
Median |
Predictive value |
|
| <353 >352 |
84.38% (+) 90.00% (-) |
||||
| Kim et al., 2009 (25) |
24 48 42 |
R0 Resection R1/2 Resection Unresectable |
Median |
Mean±SD |
|
| 49.66 233.03 174.07 |
111±156.23 (P=0.0034) 1,860±3,091 1,560±2,985 |
||||
| Kondo et al., 2010 (26) | 77 11 |
R0 Resection R1/2 Resection |
Median |
||
| 118 203 | |||||
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.