Here, we showed in large cohort of CCA patients undergoing tumor resection at a tertiary referral centre that preoperative levels of circulating CEA but not CA19-9 are an independent prognostic factor and its diagnostic value for early detection of CCA might even be superior to CA19-9 in the setting of a pre-existing benign cholangiopathy like PSC. This evidence concerns the gene CEACAM5 and pancreatic serous cystadenoma.