Serum CA19-9 determination in the management of pancreatic cancer

Background/Aim: CA19-9 is a tumor marker present in the serum of 70-90% of patients with pancreatic carcinoma. In order to investigate the value of CA19-9 determination in the clinical management of patients with pancreatic cancer, we performed a retrospective study. Material and Methods: We reviewed the records of 122 patients who were admitted to the Surgical Department of the Dijkzigt University Hospital in Rotterdam, the Netherlands, with a diagnosis of pancreatic cancer. Results: Patients with distant metastases at the time of diagnosis show a significantly higher serum CA19-9 level than patients without distant metastases. Unfortunately there is much overlap between the levels in both groups. There was no statistically significant difference in CA19-9 level between patients with a resectable tremor and a tremor that was unresectable due to local conditions. In the postoperative follow-up, there was a statistical relationship between the postoperative CA19-9 level and the development of distant metastases. However, since there is no known therapy for metastases of pancreatic carcinoma, it is not useful to detect these in an early stage. Conclusions: No useful information can be obtained from postoperative CA19-9 determinations. In the preoperative workup of a patient with a pancreatic tumor CA19-9 determination is at least helpful in estimating the probability of metastatic disease.