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dc.contributor.authorRegine, W.F.
dc.contributor.authorWinter, K.
dc.contributor.authorAbrams, R.A.
dc.date.accessioned2019-06-21T18:46:29Z
dc.date.available2019-06-21T18:46:29Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85045202910&doi=10.1016%2fj.adro.2018.01.003&partnerID=40&md5=99f621099914705e5dc05868362efdc4
dc.identifier.urihttp://hdl.handle.net/10713/9729
dc.description.abstractPurpose: NRG Oncology RTOG 9704 was the first adjuvant trial to validate the prognostic value of postresection CA19-9 levels for survival in patients with pancreatic carcinoma. The data resulting from this study also provide information about predictors of recurrence that may be used to tailor individualized management in this disease setting. This secondary analysis assessed the prognostic value of postresection CA19-9 and surgical margin status (SMS) in predicting patterns of disease recurrence. Methods and materials: This multicenter cooperative trial included participants who were enrolled as patients at oncology treatment sites in the United States and Canada. The study included 451 patients analyzable for SMS, of whom 385 were eligible for postresection CA19-9 analysis. Postresection CA19-9 was analyzed at cut points of 90, 180, and continuously. Patterns of disease recurrence included local/regional recurrence (LRR) and distant failure (DF). Multivariable analyses included treatment, tumor size, and nodal status. To adjust for multiple comparisons, a P value of ≤ .01 was considered statistically significant and > .01 to ≤ .05 to be a trend. Results: For CA19-9, 132 (34%) patients were Lewis antigen–negative (no CA19-9 expression), 200 (52%) had levels <90, and 220 (57%) had levels <180. A total of 188 patients (42%) had negative margins, 152 (34%) positive, and 111 (25%) unknown. On univariate analysis, CA19-9 cut at 90 was associated with increases in LRR (trend) and DF. Results were similar at the 180 cut point. SMS was not associated with an increase in LRR on univariate or multivariate analyses. On multivariable analysis, CA19-9 ≥ 90 was associated with increased LRR and DF. Results were similar at the 180 cut point. Conclusions: In this prospective evaluation, postresection CA19-9 was a significant predictor of both LRR and DF, whereas SMS was not. These findings support consideration of adjuvant radiation therapy dose intensification in patients with elevated postresection CA19-9. Copyright 2018en_US
dc.description.urihttps://dx.doi.org/10.1016/j.adro.2018.01.003en_US
dc.language.isoen-USen_US
dc.publisherElsevier Incen_US
dc.relation.ispartofAdvances in Radiation Oncology
dc.subjectpostresection CA19-9 levelsen_US
dc.subject.lcshPancreas--Canceren_US
dc.subject.meshAntigens, Tumor-Associated, Carbohydrateen_US
dc.subject.meshBiomarkers, Tumoren_US
dc.subject.meshPrognosisen_US
dc.subject.meshRecurrenceen_US
dc.titlePostresection CA19-9 and margin status as predictors of recurrence after adjuvant treatment for pancreatic carcinoma: Analysis of NRG oncology RTOG trial 9704en_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.adro.2018.01.003


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