Modification of BACAP score as a predictor of pancreatic carcinoma resectability at Dr. Cipto Mangunkusumo National Center Hospital Jakarta

Background: Surgery remains the best choice curative treatment for pancreatic cancer. Therefore, it is crucial to establish accurate diagnosis from the beginning. BACAP score and CA 19-9 have been identified as good predictors of pancreatic cancer resectability, and their accuracy is expected to increase when combined. This study aimed to determine the outcomes produced by the combination of the BACAP score and CA 19-9 tumor marker. Methods: This was retrospective cross-sectional study involved pancreatic cancer patients who underwent surgery between January 2017 and April 2023. Logistic regression analysis was performed on all variables of the BACAP score and CA 19-9. The primary outcomes were demographic characteristics, predictive value of BACAP score, Modified BACAP score, and CA 19-9. Results: A total 87 patients were included. BACAP score yields a sensitivity of 50.0%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 73.8%, and accuracy of 75.9% (AUC 94.6%). While modified BACAP score yielded a sensitivity of 83.1%, specificity of 85.7%, PPV of 70.5%, NPV of 92.5%, and accuracy of 83.9% (AUC 89.4%). Conclusion: The combination of CA 19-9 and the BACAP score yields a modified score with better outcomes compared to the BACAP score alone in predicting the resectability of pancreatic carcinoma.