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Retrospective Evaluation of the Influence of Postoperative Tumor Marker Status on Survival and Patterns of Recurrence After Surgery for Pancreatic Cancer Based on RECIST Guidelines

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to obtain a comprehensive understanding of the impact of postoperative tumor marker (TM) normalization on survival after pancreatectomy for pancreatic carcinoma. We propose the concept of surgical RECIST based on residual tumor and TM status.

Methods

A total of consecutive patients with pancreatic carcinoma underwent pancreatectomy between August 1, 1989, and August 1, 2008. Pre- and postoperative TM values were available for 194 patients. The relationship between TM status, survival, and other clinical and demographic data was determined with univariate log-rank tests and Cox proportional hazards analysis.

Results

Postoperative TM levels remained elevated in 92 patients (47.4%; partial responders). TM levels normalized in 102 patients (52.6%; complete responders). Lymph node metastases, portal vein resection, absence of retroperitoneal clearance, residual tumor, preoperative high CA19-9, and surgical partial response were associated with decreased survival. Nodal stage (P = 0.0227) and surgical RECIST (P = 0.025) were significant predictors of survival. Partial responders had a significantly lower median survival time (P = 0.0008) and significantly higher frequency of hepatic metastasis (P = 0.0299).

Conclusions

Postresection TM normalization is a strong prognostic factor for pancreatic cancer. The efficacy of pancreatic cancer surgery should be evaluated in the context of both local clearance and serum TM kinetics.

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Acknowledgment

This work was supported in part by Grants-in-Aid for Scientific Research (C) 21591766 from Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan

    Fuyuhiko Motoi MD, PhD, Toshiki Rikiyama MD, PhD, Yu Katayose MD, PhD, Shin-ichi Egawa MD, PhD & Michiaki Unno MD, PhD

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  1. Fuyuhiko Motoi MD, PhD
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  2. Toshiki Rikiyama MD, PhD
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  3. Yu Katayose MD, PhD
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  4. Shin-ichi Egawa MD, PhD
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  5. Michiaki Unno MD, PhD
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Correspondence to Fuyuhiko Motoi MD, PhD.

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Motoi, F., Rikiyama, T., Katayose, Y. et al. Retrospective Evaluation of the Influence of Postoperative Tumor Marker Status on Survival and Patterns of Recurrence After Surgery for Pancreatic Cancer Based on RECIST Guidelines. Ann Surg Oncol 18, 371–379 (2011). https://doi.org/10.1245/s10434-010-1311-x

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  • DOI: https://doi.org/10.1245/s10434-010-1311-x

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