• Kojiro Omiya, Atsushi Oba, Yosuke Inoue, Kosuke Kobayashi, Y H Andrew Wu, Yoshihiro Ono, Takafumi Sato, Takashi Sasaki, Masato Ozaka, Naoki Sasahira, Hiromichi Ito, Akio Saiura, and Yu Takahashi.
• Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
• Ann. Surg. 2023 Jun 1; 277 (6): e1278e1283e1278-e1283.

ObjectiveThis study investigates the use of serum DUPAN-2 in predicting the PC progression in CA19-9 nonsecretors.BackgroundAlthough we previously reported that serum CA19-9 >500U/ mL is a poor prognostic factor and an indication for enhanced neoadjuvant treatment, there is not a biomarker surrogate that equivalently predicts prognosis for CA19-9 nonsecretors.MethodsWe evaluated consecutive PC patients who underwent pancreatectomy from 2005 to 2019. All patients were categorized as either nonsecretor or secretor (CA19-9 ≤ or >2.0U/mL).ResultsOf the 984 resected PC patients, 94 (9.6%) were nonsecretors and 890 (90.4%) were secretors. The baseline characteristics were not statistically different between the 2 groups except for the level of DUPAN-2 (720 vs. 100U/mL, P < 0.001). Survival curves after resection were similar between the 2 groups (29.4 months vs. 31.3 months, P = 0.900). Survival curves of patients with DUPAN-2 >2000U/mL in the nonsecretors and patients with CA19-9 >500U/mL in the secretors were nearly equivalent as well (hazard ratio 2.08 vs. 1.89). In the multivariate analysis, DUPAN-2 >2000U/mL (hazard ratio 2.53, P = 0.010) was identified as independent prognostic factor after resection.ConclusionDUPAN-2 >2000U/mL in CA19-9 nonsecretors can be an unfavorable factor that corresponds to CA19-9 >500U/mL in CA19-9 secretors which is an indicator for enhanced neoadjuvant treatment. The current results shed light on the subset of nonsecretors with poor prognosis that were traditionally categorized in a group with a more favorable prognosis group.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

16 keywords...

hide…