Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100032, China.
Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Pancreatology. 2019 Mar;19(2):302-306. doi: 10.1016/j.pan.2019.01.023. Epub 2019 Feb 1.
CA19-9 is the most commonly used tumor marker in the diagnosis, prognosis and surveillance of pancreatic cancer. We hypothesized that CA19-9 elevation can be taken as an indication to start salvage treatment in surveillance after resection.
From January 2014 and July 2017, 80 pancreatic cancer patients who underwent R0 surgical resection and received adjuvant chemotherapy were included.
Twenty-six (32.5%) patients started salvage treatment at the time of CA19-9 elevation without radiological evidence of recurrence. Fifty-four (67.5%) patients treated conventionally before recurrence was confirmed by radiological examinations. Sixty (75%) patients had CA19-9 elevation that preceded radiographic recurrence by about 3 months. In the intervention group, the median DFS (23.6 months vs. 12.1 months, P < 0.001) and OS (28.1 months vs. 20.7 months, P = 0.049) were significantly longer than those in the control group.
CA19-9 elevation could preceded recurrence confirmed by radiographic examinations in most patients. Tumor marker-guided salvage treatment can significantly prolong disease-free survival and overall survival in patients under surveillance after pancreatic cancer resection.
CA19-9 是诊断、预后和监测胰腺癌最常用的肿瘤标志物。我们假设 CA19-9 升高可以作为在切除术后监测中开始挽救治疗的指征。
从 2014 年 1 月至 2017 年 7 月，共纳入 80 例接受 RO 手术切除和辅助化疗的胰腺癌患者。
26 例（32.5%）患者在 CA19-9 升高时开始挽救治疗，而没有影像学复发的证据。54 例（67.5%）患者在影像学检查确认复发前常规治疗。60 例（75%）患者的 CA19-9 升高在前，影像学复发约 3 个月。在干预组中，中位无进展生存期（23.6 个月 vs. 12.1 个月，P<0.001）和总生存期（28.1 个月 vs. 20.7 个月，P=0.049）明显长于对照组。
在大多数患者中，CA19-9 升高可先于影像学检查证实的复发。在胰腺癌切除术后监测中，肿瘤标志物指导的挽救治疗可显著延长无病生存期和总生存期。
