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What Do The Following Test Reports Indicate?
Question: Sir, XXXX.
Age-52 years.
Ca 19 9 -118.
Whipples procedure on 30th January 2014.
Stage T1n0m0.
Moderately diffrentiated adenocarcinoma of pancreas with involvement of surrounding fat and reactive hyperplasia of nodes 0/15.
Discharged in 2 weeks.
Post surgery - 44.
Underwent adjunct chemotherapy -gemcitabline.
6 cycles.
Ca 19 9 at the end of chemotherapy -16.41
On 5th April, 2015 ca 19 9 levels increased to 70.
under went pet ct-recurrence.
1 cm peripancreatic lymph node seen.
celiac lymph nodes metases.
Doctor planned laparotomy to remove tumor as it was localised.
The doctor removed few oval celiac lymph nodes which were poorly diffrentiated.
The doctor said the whole abdomen was free of micrometases.
Did ultrasound again after surgery.
Ultrasound report-There are two residual lymph nodes measuring 1.4 cm and 1 cm .
No evedice of neoplastic pathology anywhere else.
Folfirinox chemotherapy planned.
Liver function test are all normal.
To undergo 3 cycles of Folfirinox.
Ca 19 9 levels -250.
Please suggest survival and prognosis in my particular case .
Age-52 years.
Ca 19 9 -118.
Whipples procedure on 30th January 2014.
Stage T1n0m0.
Moderately diffrentiated adenocarcinoma of pancreas with involvement of surrounding fat and reactive hyperplasia of nodes 0/15.
Discharged in 2 weeks.
Post surgery - 44.
Underwent adjunct chemotherapy -gemcitabline.
6 cycles.
Ca 19 9 at the end of chemotherapy -16.41
On 5th April, 2015 ca 19 9 levels increased to 70.
under went pet ct-recurrence.
1 cm peripancreatic lymph node seen.
celiac lymph nodes metases.
Doctor planned laparotomy to remove tumor as it was localised.
The doctor removed few oval celiac lymph nodes which were poorly diffrentiated.
The doctor said the whole abdomen was free of micrometases.
Did ultrasound again after surgery.
Ultrasound report-There are two residual lymph nodes measuring 1.4 cm and 1 cm .
No evedice of neoplastic pathology anywhere else.
Folfirinox chemotherapy planned.
Liver function test are all normal.
To undergo 3 cycles of Folfirinox.
Ca 19 9 levels -250.
Please suggest survival and prognosis in my particular case .
Brief Answer:
Elevated Ca 19.9 after treatment suggests metastasis,PET scan required
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The overall prognosis of pancreatic cancer depends on the surgical clearance of the tumor and lymph nodes with metastasis.
You have extensive surgery as well as revision surgery for removal of main tumor and metastatic lymph nodes followed by chemotherapy.
The treatment part is going on well, however, what is worrisome is a raised level of Ca 19.9 (250) after surgery and chemotherapy.
A PET scan is suggested to know any focus of metastasis since elevated levels of Ca 19.9 indicate that.
Consult your oncologist for further work up.
Thanks and take care
Dr Shailja Puri
Elevated Ca 19.9 after treatment suggests metastasis,PET scan required
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The overall prognosis of pancreatic cancer depends on the surgical clearance of the tumor and lymph nodes with metastasis.
You have extensive surgery as well as revision surgery for removal of main tumor and metastatic lymph nodes followed by chemotherapy.
The treatment part is going on well, however, what is worrisome is a raised level of Ca 19.9 (250) after surgery and chemotherapy.
A PET scan is suggested to know any focus of metastasis since elevated levels of Ca 19.9 indicate that.
Consult your oncologist for further work up.
Thanks and take care
Dr Shailja Puri
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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