{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T04:10:15Z","timestamp":1770091815113,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Pancreatic ductal adenocarcinoma (PDAC) is characterized by limited survival rates, yet patients who achieve optimal CA19\u20109 response to neoadjuvant therapy (NAT) exhibit improved survival. This study examines the association between initial CA19\u20109 levels and survival in PDAC patients who achieved CA19\u20109 normalization with systemic chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, multi\u2010institutional analysis of patients with resectable\/borderline\u2010resectable PDAC, who underwent NAT and curative\u2010intent pancreatectomy at the University of Pittsburgh Medical Center, University of Texas Southwestern Medical Center, NorthShore University, and West Virginia University To contexualize thi\u00a0between 2010 and 2022, was performed. CA19\u20109 secretors (&gt;\u200937\u2009U\/mL, with total bilirubin &lt;\u20092) at diagnosis, with optimal response to NAT (normalization and &gt;\u200950% drop in CA19\u20109) were included. A cutoff for pre\u2010NAT CA19\u20109 of 400\u2009U\/mL was determined to maximize sensitivity and specificity for survival benefit, and the cohort was accordingly divided into two groups. Kaplan\u2013Meier and Cox proportional\u2010hazards models were used for univariate and multivariable analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 134 patients were included, 32 (23.9%) had a pre\u2010NAT CA19\u20109\u2009\u2265\u2009400U\/mL. DFS and OS were considerably higher among patients with pre\u2010NAT CA19\u20109\u2009&lt;\u2009400U\/mL (median(95%CI) in months, DFS:19.8(16.0,33.4) versus 7.8(5.0,13.0); OS:49.0(34.5,70.7) versus 23.1(13.8,50.9)). On multivariable analysis, pre\u2010NAT CA19\u20109\u2009\u2265\u2009400\u2009U\/mL was significantly associated with reduced DFS and OS (DFS:HR\u2009=\u20092.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001; OS:HR\u2009=\u20091.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this select cohort of PDAC patients with optimal NAT response, pre\u2010NAT CA19\u20109\u2009\u2265\u2009400U\/mL is strongly associated with decreased DFS and OS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70179","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:05:24Z","timestamp":1767189924000},"page":"177-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pretreatment CA19\u20109 Predicts Survival in Pancreatic Cancer With Optimal Response to Neoadjuvant Therapy"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3311-9908","authenticated-orcid":false,"given":"Anthony","family":"Gebran","sequence":"first","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asmita","family":"Chopra","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emile","family":"Farah","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Texas Southwestern Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Hays","sequence":"additional","affiliation":[{"name":"Department of Surgery NorthShore University Health System Evanston IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Ranson","sequence":"additional","affiliation":[{"name":"Department of Surgery West Virginia University Morgantown WV USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aram","family":"Rojas","sequence":"additional","affiliation":[{"name":"Department of Surgery NorthShore University Health System Evanston IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastiaan","family":"Ceuppens","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"},{"name":"Department of Surgery Erasmus Medical Center Rotterdam Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil V.","family":"Tirukkovalur","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Talamonti","sequence":"additional","affiliation":[{"name":"Department of Surgery NorthShore University Health System Evanston IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert J.","family":"Zeh","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Texas Southwestern Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8863-7409","authenticated-orcid":false,"given":"Carl","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Surgery West Virginia University Morgantown WV USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian A.","family":"Boone","sequence":"additional","affiliation":[{"name":"Department of Surgery West Virginia University Morgantown WV USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Hogg","sequence":"additional","affiliation":[{"name":"Department of Surgery NorthShore University Health System Evanston IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amer H.","family":"Zureikat","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricio M.","family":"Polanco","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Texas Southwestern Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7047-1711","authenticated-orcid":false,"given":"Alessandro","family":"Paniccia","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21763"},{"key":"e_1_2_9_3_1","unstructured":"National Cancer Institute. Cancer Stat Facts: Pancreatic Cancer.2024 accessed October 11 2024 https:\/\/seer.cancer.gov\/statfacts\/html\/pancreas.html."},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","unstructured":"C.Guyard S.Tzedakis E.Hain et al. The Role of CA 19\u20109 in Pancreatic Adenocarcinoma. In:K.S\u00f8reide S.St\u00e4ttner eds. Textbook of Pancreatic Cancer: Principles and Practice of Surgical Oncology. Cham: Springer International Publishing;2021:455\u2010466.","DOI":"10.1007\/978-3-030-53786-9_30"},{"key":"e_1_2_9_5_1","first-page":"105","article-title":"The Clinical Utility of Serum CA 19\u20109 in the Diagnosis, Prognosis and Management of Pancreatic Adenocarcinoma: An Evidence Based Appraisal","volume":"3","author":"Ballehaninna U. K.","year":"2011","journal-title":"Journal of Gastrointestinal Oncology"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.3934"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08468-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2023.01.016"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/PO.24.00193"},{"key":"e_1_2_9_10_1","unstructured":"National Comprehensive Cancer Network. NCCN Guidelines: Pancreatic Adenocarcinoma.2024 accessed October 11 2024 https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1455."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1998.50"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1385\/IJGC:32:1:35"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0670-7"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-0916-5"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-1033-0"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2809-1"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2017.11.011"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-024-01856-7"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.18.6288"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605243"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24302"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-15321-w"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004143"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70179","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.70179","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:36:06Z","timestamp":1770042966000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.70179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/jso.70179"],"URL":"https:\/\/doi.org\/10.1002\/jso.70179","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]},"assertion":[{"value":"2025-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}