Tumor marker kinetics as prognosticators in patients with unresectable gallbladder adenocarcinoma undergoing palliative chemotherapy

Jae Woo Lee, Young-Tae Kim, Sang Hyub Lee, Jun Hyuk Son, Jin Woo Kang, Ji Kon Ryu, Dong Kee Jang, Woo Hyun Paik, Ban Seok Lee

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)102-110
Number of pages9
JournalGut and Liver
Volume12
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • CA-19-9 antigen
  • Carcinoembryonic antigen
  • Gallbladder neoplasms
  • Overall survival
  • Progression-free survival

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