Prognostic value of carbohydrate antigen 19-9 in patients undergoing resection of biliary tract cancer

Abstract

Non-normalization of CA19-9 level after resection of BTC with curative intent was associated with worse OS. R1 resection was associated with a particularly poor prognosis when CA19-9 levels did not normalize.

The impact of perioperative CA19‐9 change on the survival and recurrence patterns after adjuvant chemoradiotherapy in resectable extrahepatic cholangiocarcinoma

“…Chung et al also showed that high preoperative CA19‐9 (>55 U/mL) was an independent predictor of a high risk of recurrence . On the other hand, Yamashita et al suggested that patients with high preoperative CA19‐9 that was normalized after resection had a similar OS compared with those of initially normal preoperative CA19‐9, which meant postoperative level was more relevant . Thus in extrahepatic cholangiocarcinoma, the association of preoperative CA19‐9 itself with tumor burden or prognosis requires further study.…”

“…However, not all patients will likely derive benefits from adjuvant CRT, and current guidelines based on several retrospective studies do not address personalized care. Previous studies suggested that it was reasonable to consider adjuvant therapy in patients with high preoperative CA19‐9 level that was not normalized after surgery . Previous meta‐analysis suggested the role of adjuvant therapy in patients with N1 disease and R1 resection .…”

“…So far, several studies have reported the relationship between CA19‐9 value and clinical outcomes in pancreato‐biliary cancers . Likewise, perioperative CA19‐9 value in surgically resected cholangiocarcinoma has also been recognized as a prognostic factor . Nevertheless, CA19‐9 itself is not included in current staging systems, and more evidence is needed on the role of CA19‐9 as a selection marker to apply it in clinical decision‐making, especially when considering adjuvant chemoradiotherapy (CRT).…”

“…However, the impacts of perioperative CA19‐9 change on the survival and recurrence patterns after adjuvant CRT still remain unknown. Previous studies that analyzed CA19‐9 usually had a problem of tumor heterogeneity by combining biliary tract cancers together . Moreover, adjuvant and neoadjuvant treatments were also mixed or even not considered at all, which could lead to significant biases in analyzing the effects of CA19‐9.…”

Serum Nardilysin, a Surrogate Marker for Epithelial–Mesenchymal Transition, Predicts Prognosis of Intrahepatic Cholangiocarcinoma after Surgical Resection

“…However, there are no established methods to define patient subgroups that need adjuvant strategies. The preoperative measurement of serum tumor markers may identify high-risk patients; however, few studies have investigated biomarkers in patients with ICC possibly due to the difficulties associated with collecting large numbers of serum samples from patients with ICC (9)(10)(11).…”