DOI: 10.36347/sasjs.2020.v06i07.005

Pages: 280-285

Pancreatic cancer is the fifth leading cause of cancer deaths in Western countries. Despite advances in imaging, the resectability of carcinomas of the pancreas remains very low with rates ranging from 5 to 22%. In fact, about 1/4 of the tumors found to be resectable in the preoperative assessment appear unresectable at laparotomy. This poor prognosis is attributable to late stage presentation, lack of effective treatments, early recurrence and absence of clinically useful biomarkers which can detect pancreatic cancer in its precursor forms or earliest stages. Finding a sensitive, easy, low-risk and low-cost tool for assessing resectability has been a sought-after goal for many years. We aimed to study the intrinsic validity characteristics of the CA 19-9 serum level for the evaluation of the resectability of pancreatic tumors, compared with surgical exploration data. We retrospectively reviewed, between 2014 and 2019, preoperative serum levels of CA19-9 in patients with pancreatic cancers diagnosed by imaging means. We calculated the sensitivity and specificity of the Carbohydrate antigen 19-9 (CA 19-9) to evaluate the resectability as opposed to surgical exploration. The performance of the serum CA 19-9 levels was compared with the surgical evaluation of the resectability according to receiver operating characteristic (ROC) curve analysis, in order to determine the optimum cut-off value for the CA 19-9 level preoperatively that will indicate that the pancreatic cancer is resectable. 96 patients were included. 34.3% were resectable (N = 33), and 25% were judged operable and resectable (N = 24). The mean CA 19-9 level was 250,5 U/mL in the resectable group and 794,2 U/mL in the unresectable group. The threshold value found of CA19-9 serum levels to predict resectability of pancreatic cancers was 122 U/mL with a specificity and sensitivity of 97,2% and 81,8% respectively. The positive predictive value of CA19-9 serum levels for pancreatic cancer resectability.......