Observational Study - Can combined use of tumor markers in pancreatic cancer be a solution to short-and long-term consequences? - A retrospective study

Q: What was the goal of the Ca19-9/CEA ratio analysis in this PDAC study?

The study aimed to determine how the Ca19-9/CEA ratio relates to disease prognosis and mean survival in pancreatic head ductal adenocarcinoma.

Q: How was the study conducted and who were the participants?

It was a retrospective study of 129 pancreatic head adenocarcinoma patients treated with the Whipple procedure at Ankara University Surgical Oncology Clinic between 2010 and 2020.

Q: What did the study find about the Ca19-9/CEA ratio and prognosis?

Using derived cutoff values, patients with lower versus higher Ca19-9/CEA ratios had substantially different mean survival, with statistically significant results.

Sep 24, 2026

Uploaded by Logic

Tumor markers are used to follow disease course in pancreatic ductal adenocarcinoma (PDAC), particularly after surgery, yet early-stage prognosis has shown inconsistent associations with marker levels. This retrospective study evaluates the Ca19-9/CEA ratio as a prognostic factor in pancreatic head ductal adenocarcinoma using 129 patients treated with the Whipple procedure from 2010–2020. Demographics, disease stage, CEA, CA19-9, and CEA/CA19-9 ratios were analyzed and cutoff values were derived to assess survival and stage prediction.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Methods and Data Analysis

Cutoff Values and Diagnostic Performance

Prognosis and Mean Survival

® Observational Study Can combined use of tumor markers in pancreatic cancer be a solution to short-and long-term consequences? A retrospective study Ebru Esen, MDa,* , Mehmet Aslan, MDb , Sevket Baris Morkavuk, MDa , Cem Azili, MDc , Siyar Ersoz, MDd , Ibrahim Burak Bahcecioglu, MDa , Ali Ekrem Unal, MDc | Abstract
As in other types of cancer, tumor markers are used in pancreatic ductal adenocarcinoma (PDAC) for disease follow-up, especially after surgery. There has been shown to be a significant correlation between the tumor marker levels and poor prognosis in locally or systemic advanced stage PDAC patients. However, there is no significant correlation between prognosis and marker levels in patients with early stage PDAC patients. This study aimed to examine the effect of the carbohydrate antigen 19-9 (Ca19-9)/carcinoembryogenic antigen (CEA) ratio in ductal adenocarcinoma of the pancreatic head on disease prognosis and mean survival. This retrospective study was conducted with 129 pancreatic head adenocarcinoma patients who were treated with whipple procedure at the Ankara University Surgical Oncology Clinic between 2010 and 2020. All patients’ demographics, stage of the disease, CEA, CA 19-9 levels, and CEA/Ca 19-9 ratio were enrolled and compared statistically. A new cutoff value was calculated for the Ca19-9/CEA ratio. A Ca19-9/CEA ratio >29 .77 showed 69.9% sensitivity and 70.9% specificity for the probability of the T3 and T4 stages. The cutoff value for the Ca19-9/CEA ratio was 27.18. This cutoff value had a sensitivity of 79.4% and a specificity of 80.3% for lymph node metastasis. Patients with a Ca19-9/CEA ratio below the cutoff value of 28.475 had a mean survival of 93.161 months and those with a value higher than the cutoff value had a mean survival of 28.541 months (P < .001) . A simple combination of tumor markers was determined to have higher accuracy rates in predicting tumor prognosis and in determining mean survival, which are particularly needed in early stage cancers. | | --- | | Abbrevations: Ca19-9 = carbohydrate antigen 19-9 , CEA = carcinoembryogenic antigen, CI = confidence interval , HR = hazard ratio, PDAC = pancreatic ductal adenocarcinoma. | | Keywords: pancreas cancer, prognosis, tumor markers ratio | 1. Introductıon Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer-related deaths, while PDAC is the 14th most common type of newly diagnosed cancer worldwide and the third most common cause of cancer-related deaths. [1] Although it is seen less often than other cancer types, its prognosis is extremely poor with a 5-year survival rate of < 5% . The vast majority of patients die within 4 to 6 months after diagnosis. [2] Of the patients who undergo surgical resection for curative purposes, recurrence develops in 76.6% . Diseasefree survival has been reported to be 11.7 months. [3] Despite developments in testing and imaging methods, only 20% of pancreatic cancer patients have a chance to undergo surgery at the time of diagnosis because of the anatomic localization of the pancreas gland. [4] The pancreatic gland is known to be localized in close proximity to the main vascular structures in the retroperitoneal region. Similar to all diseases of the retroperitoneal region, there is a high probability that when it is symptomatic, the size has increased and/or there has been local invasion of the vascular structures. There are no symptoms specific to PDAC. Initially, nonspecific symptoms can be observed such as abdominal pain, nausea and vomiting, and at advanced stages, symptoms such as obstructive jaundice, weight loss, back pain, and cachexia. As in other types of cancer, tumor markers are used in PDAC for the follow up of the disease, especially after surgery. With the exception of a few tumor markers (prostate The authors have no funding and conflicts of interest to disclose. The datasets generated during and/or analyzed during the current study a

FAQs

What was the goal of the Ca19-9/CEA ratio analysis in this PDAC study?

The study aimed to determine how the Ca19-9/CEA ratio relates to disease prognosis and mean survival in pancreatic head ductal adenocarcinoma.

How was the study conducted and who were the participants?

It was a retrospective study of 129 pancreatic head adenocarcinoma patients treated with the Whipple procedure at Ankara University Surgical Oncology Clinic between 2010 and 2020.

What did the study find about the Ca19-9/CEA ratio and prognosis?

Using derived cutoff values, patients with lower versus higher Ca19-9/CEA ratios had substantially different mean survival, with statistically significant results.

Sep 24, 2026

Uploaded by Logic