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Updated: Sep 19, 2025
An Orthotopic Resectional Mouse Model of Pancreatic Cancer
Published on: September 24, 2020
Survival prediction for CA19-9 non-producers with resected pancreatic cancer
Jurgis Alvikas1, Ahmed Hamed1, Nikhil Tirukkovalur1
1University of Pittsburgh Medical Center, Division of Surgical Oncology, UPMC Cancer Pavilion Room 415, 5150 Centre Ave, Pittsburgh, PA, 15232, USA.
Background:
CA 19-9 is the most commonly used biomarker for pancreatic ductal adenocarcinoma (PDAC) but prognostication is a challenge for patients with normal CA 19-9 levels. We aimed to define most important prognostic factors for overall survival in PDAC patients with normal range CA 19-9 levels.
Methods:
We performed a single-center retrospective review of PDAC patients with CA 19-9 level at diagnosis <37 U/mL who underwent curative intent resection. Cohort was divided into CA 19-9 non-producers (CA 19-9 level of <3 U/mL) and normal range CA 19-9 (between 3 U/mL and 37 U/mL). We used a multivariable Cox regression model to define the predictors of overall survival and constructed a nomogram.
Results:
271 patients were included (75 CA 19-9 non-producers and 196 with normal range CA 19-9). Non-producers had worse overall survival (27.2 months versus 33.6 months) and higher rate of recurrence after resection. Predictors of survival were CA 19-9 level, age, sex, lymph node ratio, perineural invasion, surgical margin status and adjuvant chemotherapy.
Discussion:
PDAC patients who are CA 19-9 non-producers have worse survival. Our findings highlight this high-risk subgroup, identify useful prognostic features and emphasize the ongoing need for improved biomarker development.
