The impact of perioperative CA19‐9 change on the survival and recurrence patterns after adjuvant chemoradiotherapy in resectable extrahepatic cholangiocarcinoma

摘要

Backgrounds Perioperative CA19‐9 value in pancreato‐biliary cancers has been recognized as a prognostic factor. Herein, we investigated survival differences and recurrence patterns after adjuvant chemoradiotherapy by perioperative CA19‐9 change in surgically resected extrahepatic cholangiocarcinoma. Methods Patients were divided into those with preoperative normal CA19‐9 (Group 1, n ?=?52), those with high preoperative and normalized postoperative CA19‐9 (Group 2, n ?=?80), and those with both high pre‐ and postoperative CA19‐9 (Group 3, n ?=?21). Results Depending on the group defined above, the 5‐year overall survival (OS) (59.6%, 38.7%, and 9.5%, P ??0.001) and disease‐free survival (55.8%, 31.2%, and 9.5%, P ??0.001) between the three groups differed. On multivariable analysis in patients other than group 1, poor prognosticators for OS were high postoperative CA19‐9 (HR 2.26, P ?=?0.008) and N1 disease (HR 2.33, P ?=?0.001). Group 3, compared with group 2, showed higher distant metastasis rate, shorter disease‐free interval, and higher CA19‐9 at the time of recurrence. Conclusions Survival and recurrence patterns after adjuvant chemoradiotherapy are significantly affected by perioperative CA19‐9 change. This may have important implications in patient selection for adjuvant chemoradiotherapy and clinical trial design.