THE ROLE OF CA19-9 IN PREDICTION OF RESECTABILITY OF PANCREATIC HEAD CANCER

Abstract

Background: Pancreatic head carcinoma is a quite common disease. Radiology imagings are major diagnostic modalities. However, there are limitations of CT scan and MRI in evaluation of local invasion, lymph node and distal metastasis as well as prediction of curative treatment. CA19-9 is the major tumor marker which is most frequently used in pancreatic cancer. We conduct this study to evaluate the applicability of CA19-9 concentration as an accessory factor in staging and resectability prognosis for pancreatic head cancer.

Objectives: To define the correlation of CA19-9 and tumor size, tumor differentiation, disease stages, local invasion, lymph node metastasis and distal metastasis. Then, we evaluate the CA19-9 thresholds in predicting the resectability of pancreatic head cancer.

Methods: This is a retrospective study on 84 patients with pancreatic head carcinoma treated at Department of Hepatobiliary Pancreatic Surgery of Cho Ray hospital from April 2016 to May 2019.

Results: We found no significant difference in the relation between CA19-9 concentration with tumor size, differentiation and stages, respectively. In contrast, there are significant relation between CA19-9 concentration with local invasion, lymph node and distal metastasis. At CA19-9 threshold of 100 UI/ml, the relation between CA19-9 and resectability is statistically significant (p = 0.05).

Conclusion: CA19-9 could be applied as an accessory to radiology imagings in evaluating the resectability of pancreatic head cancer. The level of CA19-9 < 100 UI/ml is a suggestive factor for tumor resectability and better outcomes.

Keywords: pancreatic head cancer, CA19-9 tumor marker, pancreaticoduodenectomy, periampulary tumor