The concentration of CA19-9 is elevated in >80% of patients with advanced pancreatic cancer, and has, therefore, been evaluated as a prognostic factor and predictive factor of treatment outcome in various forms of pancreatic cancer. Predicting patient response to surgical resection is important, as the complications of surgery can be avoided for those unlikely to respond.

Hidenori Takahashi and colleagues investigated the usefulness of serum CA19-9 for enhancing the selection effect of preoperative chemoradiation therapy to identify patients best suited to surgical resection. In this retrospective analysis, 64 patients with resectable pancreatic cancer who received preoperative chemoradiation therapy were split into two groups. Patients considered unsuitable for subsequent resection included those who did not undergo resection, or who developed recurrent disease within 6 months of surgery; patients that were considered to benefit from surgery were those who received resection and had no recurrences for more than 6 months after surgery.

“The CA19-9 alteration status was significantly associated with patients survival and merits evaluation as a prognostic factor,” comments Takahashi. All of the patients with a relative increase in serum CA19-9 concentration during preoperative chemoradiation therapy fell into the first group, whereas most of the patients (93.5%) with a substantial decrease in serum CA19-9 concentration over the same period were classified as being likely to benefit from resection.