AI Article Synopsis
- - The study examined the impact of preoperative biliary drainage methods on recurrence and survival in patients with resectable pancreatic cancer who underwent surgery from 2000 to 2012.
- - Among 193 patients analyzed, those who had percutaneous transhepatic biliary drainage (PTBD) had significantly higher rates of liver recurrence (44.8%) and poorer overall survival compared to those who received endoscopic stenting or had no drainage.
- - The findings suggest that PTBD may indicate more advanced disease in pancreatic cancer patients, leading to worse survival outcomes, with a median overall survival of just 17.5 months in the PTBD group.
Article Abstract
Background: We evaluated whether preoperative biliary drainage was predictive of recurrence and survival among patients with resectable pancreatic cancer.
Methods: Patients with pancreatic cancer who were treated with upfront surgery between 2000 and 2012 were identified and stratified by preoperative percutaneous transhepatic cholangiogram-guided drainage (PTBD), placement of endoscopic stents (ERCP), or no biliary drainage (NBD). The primary endpoint was overall survival.
Results: We identified 193 patients with resectable pancreatic head cancer (33 PTBD; 96 ERCP; and 64 NBD). Key differences between the three groups were more patients who underwent >1 preoperative biliary procedures (p = 0.004) in the PTBD cohort. PTBD patients had a significant increase in hepatic recurrence rate compared with patients who did not undergo PTBD (44.8 vs. 23.3 %, p = 0.02). PTBD patients also had worse overall survival. Median and 5-year survival for PTBD, ERCP, and NBD patients were 17.5 months and 3 %, 22.4 months and 24 %, and 28.9 months and 32 %, respectively (p = 0.002). MVA revealed that percutaneous drainage was an independent predictor of worse overall survival [HR 1.76, 95 % CI (1.05-2.99), p = 0.03].
Conclusions: Patients with resectable pancreatic cancer who receive PTBD have more advanced disease, higher hepatic recurrence, and worse survival.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918460 | PMC |
| http://dx.doi.org/10.1007/s00464-015-4075-3 | DOI Listing |
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