Jarmo Niemelä1, Hannu Syrjälä2, Pasi Ohtonen3,4, Juha Saarnio5, Raija Kallio6. 1. Department of Surgery, Oulu University Hospital and Medical Research Center, Oulu, Finland; Jarmo.Niemela@ppshp.fi. 2. Department of Infection Control, Oulu University Hospital, Oulu, Finland. 3. Division of Operative Care, Oulu University Hospital, Oulu, Finland. 4. Research Unit of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland. 5. Department of Surgery, Oulu University Hospital and Medical Research Center, Oulu, Finland. 6. Department of Oncology, Oulu University Hospital, Oulu, Finland.
Abstract
BACKGROUND: The survival benefit of chemotherapy compared to best supportive care (BSC) after percutaneous transhepatic biliary drainage (PTBD) was evaluated in patients with pancreatic or biliary tract cancer. PATIENTS AND METHODS: A retrospective registry study was conducted at a tertiary-level university hospital. The endpoint was survival measured from the PTBD and the initiation of chemotherapy. RESULTS: Among 158 patients (mean age=74 years, range=43-93 years; 51.9% women), 82 (51.9%) had pancreatic cancer and 76 (48.1%) had biliary tract cancer. After PTBD, 32 (20.3%) patients received chemotherapy and had a median survival of 11.7 months; 126 (79.7%) patients received only BSC resulting in a median survival of 1.7 months. The hazard ratio for survival at 1 year for patients who received chemotherapy compared to BSC was 0.22 (95% confidence interval=0.12-0.41, p<0.001). CONCLUSION: After PTBD, patients with pancreatic or biliary tract cancer should be critically evaluated by an oncologist to determine whether chemotherapy is possible, as it seems to significantly improve survival compared to BSC.
BACKGROUND: The survival benefit of chemotherapy compared to best supportive care (BSC) after percutaneous transhepatic biliary drainage (PTBD) was evaluated in patients with pancreatic or biliary tract cancer. PATIENTS AND METHODS: A retrospective registry study was conducted at a tertiary-level university hospital. The endpoint was survival measured from the PTBD and the initiation of chemotherapy. RESULTS: Among 158 patients (mean age=74 years, range=43-93 years; 51.9% women), 82 (51.9%) had pancreatic cancer and 76 (48.1%) had biliary tract cancer. After PTBD, 32 (20.3%) patients received chemotherapy and had a median survival of 11.7 months; 126 (79.7%) patients received only BSC resulting in a median survival of 1.7 months. The hazard ratio for survival at 1 year for patients who received chemotherapy compared to BSC was 0.22 (95% confidence interval=0.12-0.41, p<0.001). CONCLUSION: After PTBD, patients with pancreatic or biliary tract cancer should be critically evaluated by an oncologist to determine whether chemotherapy is possible, as it seems to significantly improve survival compared to BSC.
Authors: Jung Won Chun; Sang Myung Woo; Sang Hyub Lee; Jin Ho Choi; Namyoung Park; Joo Seong Kim; In Rae Cho; Woo Hyun Paik; Woo Jin Lee; Ji Kon Ryu; Yong-Tae Kim Journal: Ther Adv Med Oncol Date: 2022-08-29 Impact factor: 5.485