Chemotherapy Improves Survival After Percutaneous Biliary Drainage in Patients With Pancreatic or Biliary Tract Cancer With Biliary Obstruction.
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.
['Niemelä|Jarmo|J|', 'Syrjälä|Hannu|H|', 'Ohtonen|Pasi|P|', 'Saarnio|Juha|J|', 'Kallio|Raija|R|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000970:Antineoplastic Agents D001661:Biliary Tract Neoplasms D002779:Cholestasis D002985:Clinical Protocols D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010190:Pancreatic Neoplasms D016016:Proportional Hazards Models D016019:Survival Analysis
chemotherapy percutaneous biliary drainage Cancer biliary obstruction hyperbilirubinemia