Annals of Surgical Oncology

, Volume 19, Issue 2, pp 636–641 | Cite as

Prognostic Impact of Postoperative Serum CA 19-9 Levels in Patients with Resectable Pancreatic Cancer

  • Shojiro Hata
  • Yoshihiro Sakamoto
  • Yusuke Yamamoto
  • Satoshi Nara
  • Minoru Esaki
  • Kazuaki Shimada
  • Tomoo Kosuge
Pancreatic Tumors



Perioperative serum carbohydrate antigen 19-9 (CA 19-9) level has been reported to be a useful prognostic marker in pancreatic cancer. The object of this study was to investigate the predictive factors for survival, including preoperative and postoperative serum CA 19-9 levels in patients with pancreatic cancer.


Between 2003 and 2009, a total of 269 patients with pancreatic invasive ductal carcinoma underwent macroscopically curative resection, and pre- and postoperative (within 3 months after surgery) serum CA 19-9 levels were evaluated in all of them. The prognostic significance of clinicopathologic factors was evaluated by univariate and multivariate analyses.


Preoperative serum CA 19-9 levels were higher than normal (>37 U/ml, 38–4600 U/ml) in 218 of 269 patients. Of these, after surgery, serum CA 19-9 level returned to within a normal range in 136 patients (62%), whereas 82 patients (38%) remained in the higher-than-normal range. In univariate and multivariate analyses, node metastasis (P < 0.001) and postoperative CA 19-9 level (>37 U/ml) (P < 0.0001) were independent predictors for poor survival. Postoperative CA 19-9 level was higher in patients with microscopically positive surgical margin (P = 0.02). Hepatic recurrence and peritoneal dissemination were associated with postoperative higher CA 19-9 level.


Postoperative CA 19-9 level was associated with positive surgical margin and hepatic or peritoneal recurrence and may be a useful predictor for survival in patients with pancreatic cancer.


Pancreatic Cancer Peritoneal Dissemination Acinar Cell Carcinoma Peritoneal Recurrence Resectable Pancreatic Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Supported in part by a grant-in-aid for cancer research from the Ministry of Health Welfare and Labour of Japan (21-7-5).


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Shojiro Hata
    • 1
  • Yoshihiro Sakamoto
    • 1
  • Yusuke Yamamoto
    • 1
  • Satoshi Nara
    • 1
  • Minoru Esaki
    • 1
  • Kazuaki Shimada
    • 1
  • Tomoo Kosuge
    • 1
  1. 1.Hepatobiliary and Pancreatic Surgery DivisionNational Cancer Center HospitalTokyoJapan

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