Post-resectional CA 19-9 Values >90 are Associated With Significantly Worse Survival in Patients With Pancreatic Carcinoma Treated With Adjuvant Therapy on RTOG 9704 - Implications for Current and Future Trials

Carolyn Vachani, RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: October 31, 2007

Scientific Session: Post-resectional CA 19-9 Values >90 are Associated With Significantly Worse Survival in Patients With Pancreatic Carcinoma Treated With Adjuvant Therapy on RTOG 9704 - Implications for Current and Future Trials

Previous trials have looked at the efficacy of chemotherapy and radiation therapy given postoperatively for pancreatic cancer, with conflicting outcomes. It has been suggested that the CA 19-9 level (a tumor marker for pancreatic cancer found in the blood) after resection (Whipple) may be predictive of survival and may play a role in the results of these conflicting outcomes. Using data from a previous trial (RTOG 9704), this study set out to evaluate that suggestion.

Patients were grouped as having a post-resection CA 19-9 of >90 or <90. 385 patients had CA 19-9 levels tested and recorded, and of these, 132 were found to not express CA19-9, leaving 253 patients for analysis. 200 (79%) had values <90, 53 (21%) were >90.

The researchers found that these groups were significant predictors of survival. Median * survival for the <90 group was 22.8 months, compared with 9.6 months for the >90 group. Three-year survival was 33% in the <90 group versus 2% in the >90 group.

The results of this study show that CA 19-9 levels post resection are an important predictor of survival, and that separating patients into these groups based on CA 19-9 levels may better clarify who benefits most from combination therapy in future trials.

* The median is the “middle of the pack”, where half of the patients have died and half are alive. For instance, at 9 months, 50 patients had died and 50 were alive, 9 months is the mid point of survival, or the median. It is different from the mean, which would be average survival time.

Partially funded by an unrestricted educational grant from Bristol-Myers Squibb.