Serum levels of LDH, CEA, and CA19-9 have prognostic roles on survival in patients with metastatic pancreatic cancer receiving gemcitabine-based chemotherapy

• Published in: Cancer chemotherapy and pharmacology Vol. 73; no. 6; pp. 1163 - 1171
• Main Authors: Tas, Faruk, Karabulut, Senem, Ciftci, Rumeysa, Sen, Fatma, Sakar, Burak, Disci, Rian, Duranyildiz, Derya
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2014; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; CA-19-9 Antigen - blood; Cancer Research; Carcinoembryonic Antigen - blood; Deoxycytidine - administration & dosage; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Lactate Dehydrogenases - blood; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasm Metastasis; Oncology; Original Article; Pancreatic cancer; Pancreatic Neoplasms - blood; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - pathology; Pharmacology. Drug treatments; Pharmacology/Toxicology; Prognosis; Retrospective Studies; Tumors; LDH; Metastatic; CA19-9; Pancreatic cancer; CEA; Antineoplastic agent; Biological fluid; Prognosis; Gemcitabine; Metastasis; Pancreas cancer; Advanced stage; Serum; Pyrimidine nucleoside; Pancreatic disease; Human; Malignant tumor; Survival; Chemotherapy; Treatment; Antimetabolic; Pyrimidine derivatives; Digestive diseases; Fluorine Organic compounds; Cancer
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s00280-014-2450-8

Purpose Serum LDH, CEA, and CA19-9 levels are important tumor markers in pancreatic cancer. The purpose of this study was to evaluate the clinical significance of serum LDH, CEA, and CA19-9 levels in metastatic pancreatic cancer (MPC) receiving gemcitabine-based chemotherapy. Materials and methods In this retrospective study, we analyzed the outcome of 196 MPC patients who are treated with gemcitabine-based chemotherapy in our clinic. Results Positivity rates of serum LDH, CEA, and CA19-9 were 22, 40, and 83 %, respectively. Likewise, the rates of very high serum levels of tumor markers were correlated with these positivity rates (9 % for LDH, 30 % for CEA, and 55 % for CA19-9). The serum LDH levels were significantly higher in older patients ( p  = 0.05) and also in the patients with large tumors ( p  = 0.05), hepatic metastasis ( p  = 0.01), hypoalbuminemia ( p  = 0.01), and unresponsive to chemotherapy ( p  = 0.04). However, no correlation was found between both serum CEA and CA19-9 levels and possible prognostic factors ( p  > 0.05). The significant relationships were found between the serum levels of CEA and CA19-9 ( r s  = 0.24, p  = 0.004), and serum LDH and CEA ( r s  = 0.193, p  = 0.02). But, there was no correlation between serum LDH and CA19-9 levels ( p  = 0.39). One-year overall survival rate was 12.8 % (95 % CI 8–18). Increased serum levels of all the tumor markers significantly had adverse affect on survival ( p  = 0.001 for LDH, p  = 0.002 for CEA, and p  = 0.007 for CA19-9). However, no difference was observed in between high levels and very high levels of serum markers for all tumor markers ( p  > 0.05). Patients with normal serum levels of all three tumor markers had better outcome than others ( p  = 0.002) and those with normal serum LDH and CEA levels (whatever CA19-9) levels had associated with better survival compared with other possible alternatives ( p  < 0.001). Conclusion Serum levels of LDH, CEA, and CA19-9 had significant affect on survival in MPC patients.