Preoperative CA19-9 and PNI Stratify Survival After Resection for Recurrent PDAC

Patients with low CA19-9 and a normal immunonutritional status had a median survival of 61.7 months after resection of recurrent pancreatic cancer, versus 8.1 months when both markers were unfavorable.

• Among 44 patients, the median overall survival after curative-intent resection was 32.9 months.
• A CA19-9 above 100 U/ml and a prognostic nutritional index below 45 each independently predicted poor survival.
• Patients with pulmonary recurrence and both favorable markers survived a median of 91.5 months.

Combined CA19-9 and nutritional status may help select which patients with recurrent PDAC benefit from re-resection; this retrospective, single-cohort study supports using these markers in multidisciplinary planning, not as a strict cutoff for denying surgery.