Khorana et al listed criteria for evaluating patients with pancreatic cancer. They identified criteria for potentially curable disease. The authors are from multiple hospitals in the United States and the American Society of Clinical Oncolog (ASCO).
Patient selection: pancreatic cancer
Criteria for potentially curable pancreatic cancer - all of the following:
(1) no evidence of metastatic disease
(2) suitable candidate for a major pancreatic resection (good performance score and no significant comorbidity)
(3) no evidence of involvement of the mesenteric vasculature on high-definition imaging studies
(4) serum CA19-9 levels suggestive of localized disease AND no evidence of jaundice AND Lewis blood antigen positive
where:
• With localized cancer the CA19-9 is either low preoperatively or drops significantly after resection.
• A patient who is negative for Lewis antigen does not express CA19-9.
• Obstructive jaundice with hyperbilirubinemia is associated with an elevated serum CA19-9. If the CA19-9 is low after surgery then this suggests localized disease.
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