Abstract
Introduction
CA19-9 elevation has been reported to predict recurrence after resection of pancreatic ductal adenocarcinoma (PDAC), although only two-thirds of patients are expressers. Preoperatively, cancer-related symptoms predict outcome; however, it is unknown whether symptoms predict recurrence during surveillance, particularly for CA19-9 non-expressers.
Methods
Patients undergoing resection of PDAC at our institution from 2012 to 21 (n = 165) were retrospectively reviewed for CA19-9 and symptoms, which were correlated with recurrence-free survival (RFS). Multivariate analysis was performed using Cox regression.
Results
During postoperative surveillance, CA19-9 elevation and development of symptoms (abdominal pain, weight loss, or jaundice) were associated with worse RFS (P < .05). Multivariate analysis showed that both symptoms and CA19-9 were independently predictive of RFS (HR 1.8 [1.1-2.9; P = .025] and 2.5 [1.0-6.0; P = .048]). Among CA19-9 non-expressers (n = 51), development of symptoms was associated with detection of recurrence (P = .012).
Conclusions
Among CA19-9 non-expressers, development of symptoms predicted recurrence, providing a useful tool for recurrence detection in these patients.
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