Gut Liver.
2018 Jan;12(1):102-110. 10.5009/gnl16588.
Tumor Marker Kinetics as Prognosticators in Patients with Unresectable Gallbladder Adenocarcinoma Undergoing Palliative Chemotherapy
- Affiliations
-
- 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. gidoctor@snuh.org
- 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
- 3Department of Internal Medicine, Dongguk University Ilsan Medical Center, Goyang, Korea.
- 4Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea.
- 5Department of Internal Medicine, Gimhae Jungang Hospital, Gimhae, Korea.
- KMID: 2404724
- DOI: http://doi.org/10.5009/gnl16588
Abstract
- BACKGROUND/AIMS
To determine the prognostic value of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 in gallbladder cancer (GBC) during palliative chemotherapy.
METHODS
One hundred and twenty-three patients with pathologically confirmed unresectable GBC were included. Differences in serum CEA and CA 19-9 levels before and after chemotherapy were measured. Receiver operating characteristic curve analysis, Kaplan-Meier analyses of CEA, CA 19-9, and combined changes were performed to assess the optimal cutoff values and survival rates.
RESULTS
Patients with decreased tumor markers had significantly better progression-free survival (PFS) and overall survival (OS) than patients with increased tumor markers. The pre- and postchemotherapy CA 19-9 ratio had the highest area-under-the-curve values for predicting 3-month PFS and 1-year OS. In the multivariate analysis, increases in serum CA 19-9 during palliative chemotherapy in patients with unresectable GBC was an independent prognosticator of poor PFS and OS, with hazard ratios of 2.20 (p=0.001) and 1.67 (p=0.020), respectively. Patients with increases >10-fold were considered to have progressive disease, whereas individuals with increases >3-fold were likely to benefit from early imaging follow-up.
CONCLUSIONS
CA 19-9 kinetics was a reliable prognosticator of PFS and OS in patients with unresectable GBC who underwent palliative chemotherapy.
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