THE PROGNOSTIC VALUE OF PREOPERATIVE SERUM LEVELS OF CA-19-9 AND CEA IN PATIENTS WITH PANCREATIC-CANCER

The prognostic value of preoperative serum levels of CA 19-9 and CEA w as evaluated in 160 patients with pancreatic cancer. The survival of p atients whose tumour marker value was below a certain cut-off level wa s compared with the survival of those with a higher value using the lo g-rank test. The lowest cut-off level dividing patients into groups wi th significant difference in survival (P<0.05) was determined by graph ical analysis of chi-square values at different cut-off levels. If sta ge of disease was not taken into account, there was a significant diff erence in survival between patients with low vs high preoperative CA 1 9-9 and CEA levels. When patients were classified according to stage, a difference was found for CA 19-9 in stage II-III patients. Patients with preoperative CA 19-9 below 370 U ml(-1) had a significantly bette r prognosis than those with a higher level (P<0.05). In stage I and st age IV patients, no significant difference was found between the group s at any cut-off level. The analysis of CEA showed a significant diffe rence in survival only in stage IV patients, with CEA above 15 ng ml(- 1) being associated with shorter survival. In conclusion, in patients with stage II-III disease, particularly in patients with a non-resecta ble tumour, in whom the exact spread of the disease may be difficult t o evaluate even at operation, the preoperative CA 19-9 level seems to have a prognostic value.