Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction - A Single Center Retrospective Study

Daisuke Muroya; Hirotoshi Tsuru; Hisaaki Shimokobe; Yuichi Nagao; Yasunori Yoshimoto; Yoshito Wada; Kouji Hayashi; Satoshi Taniwaki; Ryuta Midorikawa; Shinichi Taniwaki; Satoki Kojima; Shoichiro Arai; Takahisa Shirahama; Yuichi Goto; Hisamune Sakai; Munehiro Yoshitomi; Toru Hisaka; Yoshito Akagi; Koji Okuda

doi:10.21873/anticanres.15903

Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction - A Single Center Retrospective Study

Daisuke Muroya, Hirotoshi Tsuru, Hisaaki Shimokobe, Yuichi Nagao, Yasunori Yoshimoto, Yoshito Wada, Kouji Hayashi, Satoshi Taniwaki, Ryuta Midorikawa, Shinichi Taniwaki, Satoki Kojima, Shoichiro Arai, Takahisa Shirahama, Yuichi Goto, Hisamune Sakai, Munehiro Yoshitomi, Toru Hisaka, Yoshito Akagi, Koji Okuda

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Background/Aim: Malignant biliary obstruction (MBO) is a life-threatening condition. We aimed to investigate the outcome of salvage percutaneous transhepatic biliary drainage (PTBD) in patients with unresectable MBO due to failure of management by endoscopic retrograde cholangiopancreatography (ERCP) and/or prior surgical bypass. Patients and Methods: Fifty-two consecutive patients (mean age, 69 years; 44.2% women) underwent salvage PTBD between 2013 and 2020. Results: The median overall survival rate was 4.2 months, with a 95% confidence interval (CI) of 1.9-5.7. The median overall survival (OS) were 11.1 months and 1.9 months for patients who underwent chemotherapy (n=17) and best supportive care (n=35), respectively (p=0.0005). Independent factors predicting poor outcome were best supportive care, with a hazard ratio (HR) of 3.3 (95%CI=1.3-8.5), American Society of Anesthesiologists physical status classification (ASA) with a HR of 13.5 (95%CI=1.3-136.0) and Eastern Cooperative Oncology Group (ECOG) performance status of 4, with a HR of 3.3 (95%CI=1.0-6.2). Conclusion: Salvage PTBD with chemotherapy has the potential to achieve prolonged survival in patients with unresectable MBO, including those with failure of ERCP and/or surgical bypass.

Original language	English
Pages (from-to)	4063-4070
Number of pages	8
Journal	Anticancer research
Volume	42
Issue number	8
DOIs	https://doi.org/10.21873/anticanres.15903
Publication status	Published - 08-2022
Externally published	Yes

All Science Journal Classification (ASJC) codes

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.21873/anticanres.15903

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Muroya, D., Tsuru, H., Shimokobe, H., Nagao, Y., Yoshimoto, Y., Wada, Y., Hayashi, K., Taniwaki, S., Midorikawa, R., Taniwaki, S., Kojima, S., Arai, S., Shirahama, T., Goto, Y., Sakai, H., Yoshitomi, M., Hisaka, T., Akagi, Y., & Okuda, K. (2022). Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction - A Single Center Retrospective Study. Anticancer research, 42(8), 4063-4070. https://doi.org/10.21873/anticanres.15903

@article{43749c36f2bd4998b24deff3ab3be6fa,

title = "Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction - A Single Center Retrospective Study",

abstract = "Background/Aim: Malignant biliary obstruction (MBO) is a life-threatening condition. We aimed to investigate the outcome of salvage percutaneous transhepatic biliary drainage (PTBD) in patients with unresectable MBO due to failure of management by endoscopic retrograde cholangiopancreatography (ERCP) and/or prior surgical bypass. Patients and Methods: Fifty-two consecutive patients (mean age, 69 years; 44.2% women) underwent salvage PTBD between 2013 and 2020. Results: The median overall survival rate was 4.2 months, with a 95% confidence interval (CI) of 1.9-5.7. The median overall survival (OS) were 11.1 months and 1.9 months for patients who underwent chemotherapy (n=17) and best supportive care (n=35), respectively (p=0.0005). Independent factors predicting poor outcome were best supportive care, with a hazard ratio (HR) of 3.3 (95%CI=1.3-8.5), American Society of Anesthesiologists physical status classification (ASA) with a HR of 13.5 (95%CI=1.3-136.0) and Eastern Cooperative Oncology Group (ECOG) performance status of 4, with a HR of 3.3 (95%CI=1.0-6.2). Conclusion: Salvage PTBD with chemotherapy has the potential to achieve prolonged survival in patients with unresectable MBO, including those with failure of ERCP and/or surgical bypass.",

keywords = "malignant biliary obstruction, PTBD",

author = "Daisuke Muroya and Hirotoshi Tsuru and Hisaaki Shimokobe and Yuichi Nagao and Yasunori Yoshimoto and Yoshito Wada and Kouji Hayashi and Satoshi Taniwaki and Ryuta Midorikawa and Shinichi Taniwaki and Satoki Kojima and Shoichiro Arai and Takahisa Shirahama and Yuichi Goto and Hisamune Sakai and Munehiro Yoshitomi and Toru Hisaka and Yoshito Akagi and Koji Okuda",

year = "2022",

month = aug,

doi = "10.21873/anticanres.15903",

language = "English",

volume = "42",

pages = "4063--4070",

journal = "Anticancer research",

issn = "0250-7005",

publisher = "International Institute of Anticancer Research",

number = "8",

}

Muroya, D, Tsuru, H, Shimokobe, H, Nagao, Y, Yoshimoto, Y, Wada, Y, Hayashi, K, Taniwaki, S, Midorikawa, R, Taniwaki, S, Kojima, S, Arai, S, Shirahama, T, Goto, Y, Sakai, H, Yoshitomi, M, Hisaka, T, Akagi, Y & Okuda, K 2022, 'Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction - A Single Center Retrospective Study', Anticancer research, vol. 42, no. 8, pp. 4063-4070. https://doi.org/10.21873/anticanres.15903

TY - JOUR

T1 - Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction - A Single Center Retrospective Study

AU - Muroya, Daisuke

AU - Tsuru, Hirotoshi

AU - Shimokobe, Hisaaki

AU - Nagao, Yuichi

AU - Yoshimoto, Yasunori

AU - Wada, Yoshito

AU - Hayashi, Kouji

AU - Taniwaki, Satoshi

AU - Midorikawa, Ryuta

AU - Taniwaki, Shinichi

AU - Kojima, Satoki

AU - Arai, Shoichiro

AU - Shirahama, Takahisa

AU - Goto, Yuichi

AU - Sakai, Hisamune

AU - Yoshitomi, Munehiro

AU - Hisaka, Toru

AU - Akagi, Yoshito

AU - Okuda, Koji

PY - 2022/8

Y1 - 2022/8

N2 - Background/Aim: Malignant biliary obstruction (MBO) is a life-threatening condition. We aimed to investigate the outcome of salvage percutaneous transhepatic biliary drainage (PTBD) in patients with unresectable MBO due to failure of management by endoscopic retrograde cholangiopancreatography (ERCP) and/or prior surgical bypass. Patients and Methods: Fifty-two consecutive patients (mean age, 69 years; 44.2% women) underwent salvage PTBD between 2013 and 2020. Results: The median overall survival rate was 4.2 months, with a 95% confidence interval (CI) of 1.9-5.7. The median overall survival (OS) were 11.1 months and 1.9 months for patients who underwent chemotherapy (n=17) and best supportive care (n=35), respectively (p=0.0005). Independent factors predicting poor outcome were best supportive care, with a hazard ratio (HR) of 3.3 (95%CI=1.3-8.5), American Society of Anesthesiologists physical status classification (ASA) with a HR of 13.5 (95%CI=1.3-136.0) and Eastern Cooperative Oncology Group (ECOG) performance status of 4, with a HR of 3.3 (95%CI=1.0-6.2). Conclusion: Salvage PTBD with chemotherapy has the potential to achieve prolonged survival in patients with unresectable MBO, including those with failure of ERCP and/or surgical bypass.

AB - Background/Aim: Malignant biliary obstruction (MBO) is a life-threatening condition. We aimed to investigate the outcome of salvage percutaneous transhepatic biliary drainage (PTBD) in patients with unresectable MBO due to failure of management by endoscopic retrograde cholangiopancreatography (ERCP) and/or prior surgical bypass. Patients and Methods: Fifty-two consecutive patients (mean age, 69 years; 44.2% women) underwent salvage PTBD between 2013 and 2020. Results: The median overall survival rate was 4.2 months, with a 95% confidence interval (CI) of 1.9-5.7. The median overall survival (OS) were 11.1 months and 1.9 months for patients who underwent chemotherapy (n=17) and best supportive care (n=35), respectively (p=0.0005). Independent factors predicting poor outcome were best supportive care, with a hazard ratio (HR) of 3.3 (95%CI=1.3-8.5), American Society of Anesthesiologists physical status classification (ASA) with a HR of 13.5 (95%CI=1.3-136.0) and Eastern Cooperative Oncology Group (ECOG) performance status of 4, with a HR of 3.3 (95%CI=1.0-6.2). Conclusion: Salvage PTBD with chemotherapy has the potential to achieve prolonged survival in patients with unresectable MBO, including those with failure of ERCP and/or surgical bypass.

KW - malignant biliary obstruction

KW - PTBD

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U2 - 10.21873/anticanres.15903

DO - 10.21873/anticanres.15903

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C2 - 35896223

AN - SCOPUS:85135107421

SN - 0250-7005

VL - 42

SP - 4063

EP - 4070

JO - Anticancer research

JF - Anticancer research

IS - 8

ER -

Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction - A Single Center Retrospective Study

Abstract

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