Anzeige
Erschienen in:
01.08.2008 | original article
Prognosis of Resected Ampullary Adenocarcinoma by Preoperative Serum CA19-9 Levels and Platelet-Lymphocyte Ratio
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 8/2008
Einloggen, um Zugang zu erhaltenAbstract
Background
The objective of this study was to evaluate whether preoperative CA19-9 levels and the platelet–lymphocyte ratio (PLR) might reflect prognostic indices for resected ampullary adenocarcinoma.
Materials and Methods
Data were collected prospectively over a 10-year period for consecutive patients undergoing pancreatoduodenectomy for malignancy.
Results
Both preoperative PLR and CA19-9 results were available in 52 cases of resected ampullary adenocarcinoma. Preoperative CA19-9 levels of ≤150 kU/l (or ≤300 kU/l in the presence of bilirubin levels >35 µmol/l) and a PLR of ≤160 were found to represent the optimal cut-off values to risk stratify patients. If both levels were elevated (n = 8), patients had a median overall survival of 10.1 months. If either CA19-9 or PLR were elevated individually (n = 23), patients had a median survival of 25.2 months. For cases where both levels were less than the cut-off values (n = 21), the median overall survival time was not reached but was greater than 60 months (log rank, p < 0.001). This preoperative risk stratification was found to remain a significant independent predictor of survival on multivariate analysis (Cox, p = 0.001) alongside resection margin status (p = 0.002) and tumor size (p = 0.051).
Conclusions
Preoperative CA19-9 and PLR both merit further evaluation as prognostic indices in resected ampullary adenocarcinoma.