Preoperative serum carbohydrate antigen 19-9 levels predict early recurrence after the resection of early-stage pancreatic ductal adenocarcinoma

Table 1 Patient demographics

Characteristics	Patients, n = 407 (%)
Age in yr, median (range)	62 (30-88)
Sex, n (%)
Male	225 (55.3)
Female	182 (44.7)
BMI in kg/m2, median (range)	23.2 (15.3-31.6)
Pre-op CA 19-9 in U/mL, n (%)
Normal	167 (41)
Abnormal	240 (59)
Tumor location, n (%)
Head/uncinate	254 (62.4)
Neck/body/tail	151 (37.1)
Head/body	2 (0.5)
Tumor size, median, cm (range)	2.5 (0.3-4.0)
Total number of harvested lymph nodes, median (range)	14 (1-74)
Differentiation, n (%)
Well	60 (14.9)
Poor	288 (71.6)
Unknown	54 (13.4)
Moderate	5 (1.2)
Stage, n (%)
IA	109 (26.8)
IB	298 (73.2)
Adjuvant chemotherapy, n (%)
No	154 (37.8)
Yes	253 (62.2)
Recurrence within 6 mo, n (%)
No	309 (75.9)
Yes	98 (24.1)

BMI: Body mass index; CA 19-9: Carbohydrate antigen 19-9.

Table 2 Univariate and multivariate analyses of the factors associated with early recurrence

Factors	Number of patients, n (%)	Univariate, P value	Odds ratio (95%CI)	Multivariate, P value
Age in yr		0.211	`
< 65	234 (57.5)
≥ 65	173 (42.5)
Sex		0.261
Male	225 (55.3)
Female	182 (44.7)
Tumor size in cm		< 0.001		0.004
< 2.85	244 (60.0)
≥ 2.85	163 (40.0)		2.039 (1.251-3.323)
RM		0.555		0.638
Negative	348 (85.5)
Positive	59 (14.5)		1.177 (0.583-2.287)
Tumor location		0.394
Head/uncinate	254 (62.4)
Neck/body/tail	151 (37.1)
Differentiation		0.005		0.019
Well	60 (14.9)
Moderate	288 (71.6)	0.196	1.430 (0.652–3.133)	0.372
Poor	54 (13.4)	0.005	3.493 (1.377–8.858)	0.008
CA 19-9 in U/mL		< 0.001		0.006
< 70	226 (55.5)
≥ 70	181 (44.5)		1.987 (1.217–3.243)
LVi		0.126		0.372
No	263 (64.6)
Yes	144 (35.4)		1.270 (0.749–2.144)
PNi		0.517		0.911
No	110 (27.0)
Yes	297 (73.0)		0.966 (0.535–1.780)
NLR		0.768
< 2	244 (60.0)
≥ 2	163 (40.0)
Adj. CTx.		0.059		0.025
No	154 (37.8)
Yes	253 (62.2)		0.573 (0.352–0.933)

Adj. CTx.: Adjuvant chemotherapy; CA 19-9: Carbohydrate antigen 19-9; CI: Confidence interval; LVi: Lymphovascular invasion; NLR; Neutrophil-lymphocyte ratio; PNi; Perineural invasion; RM: Resection margin.

Table 3 Comparisons between the early and non-early recurrence group

Factors	Early recurrence, n (%)	Non-early recurrence, n (%)	P value
	N = 98 (24.1%)	N = 309 (75.9%)
Age in yr			0.21
<65	51 (52.0)	183 (59.2)
≥ 65	47 (48.0)	126 (40.8)
Sex			0.261
Male	59 (60.2)	166 (53.7)
Female	39 (39.8)	143 (46.3)
Tumor size, median in cm			0.001
< 2.5	23 (23.5)	129 (41.7)
≥ 2.5	75 (76.5)	180 (58.3)
RM			0.555
Negative	82 (83.7)	266 (86.1)
Positive	16 (16.3)	43 (13.9)
Tumor location			0.712
Head/uncinate	63 (64.3)	191 (62.2)
Neck/body/tail	35 (35.7)	116 (37.8)
Differentiation			0.002
Well	9 (9.2)	51 (16.5)
Moderate	65 (66.3)	223 (72.2)
Poor	22 (22.4)	32 (10.4)
Preoperative CA 19-9 in U/mL			0.004
Normal	28 (28.6)	139 (45.0)
Abnormal	70 (71.4)	170 (55.0)
LVi			0.125
No	57 (58.2)	206 (66.7)
Yes	41 (41.8)	103 (33.3)
PNi			0.516
No	24 (24.5)	86 (27.8)
Yes	74 (75.5)	223 (72.2)
NLR			0.768
< 2	60 (61.2)	184 (59.5)
≥ 2	38 (38.8)	125 (40.5)
Adj. CTx.			0.058
No	45 (45.9)	109 (35.3)
Yes	53 (54.1)	200 (64.7)
Recurrence pattern			0.121
Local	26 (26.5)	73 (35.4)
Systemic	72 (73.5)	133 (64.6)

Adj. CTx.: Adjuvant chemotherapy; CA 19-9: Carbohydrate antigen 19-9; LVi: Lymphovascular invasion; N: Total number of patients; NLR: Neutrophil-lymphocyte ratio; PNi: Perineural invasion; RM: Resection margin.