CEA and CA 19-9 combined tumor marker index as a prognostic tool for metastatic pancreatic cancer: is two better than one?

Metastatic pancreatic cancer (PC) is one of the cancers with the worst prognosis, and prognostic tests are lacking in this population. If an effective prognostic indicator can be identified, the patient population can be monitored more closely. This retrospective study aimed to investigate the prognostic impact of tumor marker index (TMI) in patients with metastatic PC. Patients diagnosed with metastatic PC at Aydın Adnan Menderes University between 2019 and 2024 were included in the study. Demographic data, tumor marker levels, and treatment received were recorded. The prognostic value of TMI was determined as 3.15 using the receiver operating characteristic (ROC) method. Progression-free survival (PFS) and overall survival (OS) were recorded. 218 metastatic PC patients with a median follow-up duration of 10.81 months were included in the study. The median PFS was 7.26 months for the High TMI group, while it was 10.76 months for the Low TMI group (P=0.003). The median OS of patients with high TMI was 9.3 months, which was significantly lower than the 17.9 months observed in the low TMI group (P<0.001). TMI is a simple and, cost-effective prognostic tool for metastatic PC, and a higher TMI is associated with poorer survival outcomes.