Prognostic value of CA 19-9 elimination rate for mortality in metastatic pancreatic cancer

Abstract

Aim: To evaluate the prognostic value of the CA 19-9 elimination rate on survival in patients with metastatic pancreatic cancer.

Materials and Methods: This single-center retrospective cohort study included 103 adult patients with metastatic pancreatic ductal adenocarcinoma who received systemic therapy. The CA 19-9 elimination rate was calculated using baseline and 3-month values. The optimal cut-off value was determined using maximally selected rank statistics. Overall survival was analyzed using the Kaplan–Meier method and compared using the log-rank test.

Results: The mean age of the patients was 64±10.1 years, and the overall mortality rate during follow-up was 87.4%. No significant differences were observed between mortality groups with respect to demographic, clinical, or pathological characteristics (all p>0.05). The optimal cut-off value for the elimination rate (ER) was 2.33 (ER ≥ 2.33: high elimination; < 2.33: low elimination). Median overall survival was 25 months (95% CI: 17–31) in the high-elimination group and 8 months (95% CI: 7–14) in the low-elimination group (p = 0.043). The 12-, 36-, and 60-month survival rates were 80.4%, 18.3%, and 11% in the high-elimination group, compared with 37.6%, 2.2%, and 0% in the low-elimination group.

Conclusion: The CA 19-9 elimination rate is a significant prognostic biomarker for survival in patients with metastatic pancreatic cancer. A higher elimination rate is associated with improved short- and long-term survival outcomes, suggesting its potential utility for risk stratification and for assessing treatment response in clinical practice.