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Medline ® Abstract for Reference 19

of 'Ampullary carcinoma: Epidemiology, clinical manifestations, diagnosis and staging'

19
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Prognosis of resected ampullary adenocarcinoma by preoperative serum CA19-9 levels and platelet-lymphocyte ratio.
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Smith RA, Ghaneh P, Sutton R, Raraty M, Campbell F, Neoptolemos JP
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J Gastrointest Surg. 2008;12(8):1422. Epub 2008 Jun 10.
 
BACKGROUND: The objective of this study was to evaluate whether preoperative CA19-9 levels and the platelet-lymphocyte ratio (PLR) might reflect prognostic indices for resected ampullary adenocarcinoma.
MATERIALS AND METHODS: Data were collected prospectively over a 10-year period for consecutive patients undergoing pancreatoduodenectomy for malignancy.
RESULTS: Both preoperative PLR and CA19-9 results were available in 52 cases of resected ampullary adenocarcinoma. Preoperative CA19-9 levels of</=150 kU/l (or</=300 kU/l in the presence of bilirubin levels>35 micromol/l) and a PLR of</=160 were found to represent the optimal cut-off values to risk stratify patients. If both levels were elevated (n = 8), patients had a median overall survival of 10.1 months. If either CA19-9 or PLR were elevated individually (n = 23), patients had a median survival of 25.2 months. For cases where both levels were less than the cut-off values (n = 21), the median overall survival time was not reached but was greater than 60 months (log rank, p<0.001). This preoperative risk stratification was found to remain a significant independent predictor of survival on multivariate analysis (Cox, p = 0.001) alongside resection margin status (p = 0.002) and tumor size (p = 0.051).
CONCLUSIONS: Preoperative CA19-9 and PLR both merit further evaluation as prognostic indices in resected ampullary adenocarcinoma.
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Division of Surgery and Oncology, School of Cancer Studies, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby St., Liverpool, L69 3GA, UK.
PMID