Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage
Abstract Purpose To evaluate the impact of cholangitis on survival of patients with gastrointestinal cancer and malignant biliary obstruction treated with percutaneous transhepatic biliary drainage (PTBD). Methods A retrospective registry study was performed at a tertiary center from 2000 to 2016 in...
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ftdoajarticles:oai:doaj.org/article:c86dce0e5d4f4413b68e7038d7d93d57 2023-05-15T17:42:46+02:00 Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage Jarmo Niemelä Raija Kallio Pasi Ohtonen Juha Saarnio Hannu Syrjälä 2023-03-01T00:00:00Z https://doi.org/10.1186/s12876-023-02704-8 https://doaj.org/article/c86dce0e5d4f4413b68e7038d7d93d57 EN eng BMC https://doi.org/10.1186/s12876-023-02704-8 https://doaj.org/toc/1471-230X doi:10.1186/s12876-023-02704-8 1471-230X https://doaj.org/article/c86dce0e5d4f4413b68e7038d7d93d57 BMC Gastroenterology, Vol 23, Iss 1, Pp 1-8 (2023) Cancer Biliary obstruction Percutaneous biliary drainage Cholangitis Survival Diseases of the digestive system. Gastroenterology RC799-869 article 2023 ftdoajarticles https://doi.org/10.1186/s12876-023-02704-8 2023-04-09T00:35:23Z Abstract Purpose To evaluate the impact of cholangitis on survival of patients with gastrointestinal cancer and malignant biliary obstruction treated with percutaneous transhepatic biliary drainage (PTBD). Methods A retrospective registry study was performed at a tertiary center from 2000 to 2016 in Northern Finland. Results The study included 588 patients, 258 (43.9%) patients with pancreatic cancer, 222 (37.7%) with biliary tract cancer, and 108 (18.4%) with metastasis from gastrointestinal cancers. Patient mean age was 70 years, range 26 − 93 years. There were 288 [49.0%] women. The 30-day mortality rate was 30.8% for 156 patients with cholangitis before PTBD, 19.5% for 215 patients with cholangitis after PTBD and 25.8% for 217 patients without cholangitis (P = 0.039). The median survival was 1.8 months for patients with cholangitis before PTBD, 3.0 months for patients with cholangitis after PTBD, and 3.2 months for patients without cholangitis (P = 0.002). The hazard ratio (HR) for 1-year mortality for patients with cholangitis before PTBD was 1.3 (95% CI 1.06 − 1.67, P = 0.015) compared to patients with cholangitis after PTBD. After successful PTBD, 54 out of 291 patients received chemotherapy; the median survival was 5.2 months with cholangitis before PTBD, 9.4 months with cholangitis after PTBD and 15.3 months without cholangitis. Conclusion In gastrointestinal cancers with malignant biliary obstruction, survival is poorer if cholangitis occurs before PTBD compared to cholangitis after PTBD. An oncologist’s consultation is essential for assessing the possibility of chemotherapy in successfully treated PTBD patients, because of the notable survival benefit. Article in Journal/Newspaper Northern Finland Directory of Open Access Journals: DOAJ Articles BMC Gastroenterology 23 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Cancer Biliary obstruction Percutaneous biliary drainage Cholangitis Survival Diseases of the digestive system. Gastroenterology RC799-869 |
spellingShingle |
Cancer Biliary obstruction Percutaneous biliary drainage Cholangitis Survival Diseases of the digestive system. Gastroenterology RC799-869 Jarmo Niemelä Raija Kallio Pasi Ohtonen Juha Saarnio Hannu Syrjälä Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage |
topic_facet |
Cancer Biliary obstruction Percutaneous biliary drainage Cholangitis Survival Diseases of the digestive system. Gastroenterology RC799-869 |
description |
Abstract Purpose To evaluate the impact of cholangitis on survival of patients with gastrointestinal cancer and malignant biliary obstruction treated with percutaneous transhepatic biliary drainage (PTBD). Methods A retrospective registry study was performed at a tertiary center from 2000 to 2016 in Northern Finland. Results The study included 588 patients, 258 (43.9%) patients with pancreatic cancer, 222 (37.7%) with biliary tract cancer, and 108 (18.4%) with metastasis from gastrointestinal cancers. Patient mean age was 70 years, range 26 − 93 years. There were 288 [49.0%] women. The 30-day mortality rate was 30.8% for 156 patients with cholangitis before PTBD, 19.5% for 215 patients with cholangitis after PTBD and 25.8% for 217 patients without cholangitis (P = 0.039). The median survival was 1.8 months for patients with cholangitis before PTBD, 3.0 months for patients with cholangitis after PTBD, and 3.2 months for patients without cholangitis (P = 0.002). The hazard ratio (HR) for 1-year mortality for patients with cholangitis before PTBD was 1.3 (95% CI 1.06 − 1.67, P = 0.015) compared to patients with cholangitis after PTBD. After successful PTBD, 54 out of 291 patients received chemotherapy; the median survival was 5.2 months with cholangitis before PTBD, 9.4 months with cholangitis after PTBD and 15.3 months without cholangitis. Conclusion In gastrointestinal cancers with malignant biliary obstruction, survival is poorer if cholangitis occurs before PTBD compared to cholangitis after PTBD. An oncologist’s consultation is essential for assessing the possibility of chemotherapy in successfully treated PTBD patients, because of the notable survival benefit. |
format |
Article in Journal/Newspaper |
author |
Jarmo Niemelä Raija Kallio Pasi Ohtonen Juha Saarnio Hannu Syrjälä |
author_facet |
Jarmo Niemelä Raija Kallio Pasi Ohtonen Juha Saarnio Hannu Syrjälä |
author_sort |
Jarmo Niemelä |
title |
Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage |
title_short |
Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage |
title_full |
Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage |
title_fullStr |
Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage |
title_full_unstemmed |
Impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage |
title_sort |
impact of cholangitis on survival of patients with malignant biliary obstruction treated with percutaneous transhepatic biliary drainage |
publisher |
BMC |
publishDate |
2023 |
url |
https://doi.org/10.1186/s12876-023-02704-8 https://doaj.org/article/c86dce0e5d4f4413b68e7038d7d93d57 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_source |
BMC Gastroenterology, Vol 23, Iss 1, Pp 1-8 (2023) |
op_relation |
https://doi.org/10.1186/s12876-023-02704-8 https://doaj.org/toc/1471-230X doi:10.1186/s12876-023-02704-8 1471-230X https://doaj.org/article/c86dce0e5d4f4413b68e7038d7d93d57 |
op_doi |
https://doi.org/10.1186/s12876-023-02704-8 |
container_title |
BMC Gastroenterology |
container_volume |
23 |
container_issue |
1 |
_version_ |
1766144683444011008 |