ウエムラ シユウイチロウ   UEMURA Shuichiro
  植村 修一郎
   所属   医学部 医学科(東京女子医科大学病院)
   職種   助教
論文種別 原著
言語種別 英語
査読の有無 査読なし
表題 Negative prognostic outcomes of percutaneous transhepatic biliary drainage in distal cholangiocarcinoma: a retrospective analysis using propensity score matching.
掲載誌名 正式名:International journal of clinical oncology
略  称:Int J Clin Oncol
ISSNコード:14377772/13419625
掲載区分国内
巻・号・頁 26(8),pp.1492-1499
著者・共著者 MATSUNAGA Yutaro†, HIGUCHI Ryota, YAZAWA Takehisa, UEMURA Shuichiro, IZUMO Wataru, OTA Takahiro, FURUKAWA Toru, YAMAMOTO Masakazu
発行年月 2021/08
概要 BACKGROUND:The efficacy of different types of preoperative biliary drainage for cholangiocarcinoma has been debated over the past two decades. Controversy concerning the use of percutaneous transhepatic biliary drainage (PTBD) versus endoscopic biliary drainage (EBD) still exists. This study aimed to compare the long-term outcomes between PTBD and EBD in patients with distal cholangiocarcinoma.METHODS:Data of patients diagnosed with distal cholangiocarcinoma who underwent preoperative PTBD or EBD from January 1999 to December 2017 were analyzed retrospectively. Post-surgical outcomes, including the incidence of post-operative complications, peritoneal metastasis, disease-free survival, and overall survival, were analyzed. Survival analyses were also performed after propensity score matching in the PTBD and EBD groups.RESULTS:The incidence of post-operative complications was similar in both groups. The 5-year estimated cumulative incidences for peritoneal metastasis were 14.7% and 7.2% in the PTBD and EBD groups, respectively (p = 0.192). The 5-year disease-free survival rates were 23.7% and 47.3% in the PTBD and EBD groups, respectively (p = 0.015). In the multi-variate analysis for overall survival, PTBD was an independent poor prognostic factor. The 5-year overall survival rates were 35.9% and 56.3% in the PTBD and EBD groups, respectively (hazard ratio 1.85, confidence interval 1.05-3.26, p = 0.035). The results after propensity score matching indicated a poorer prognosis in the PTBD group, with a 5-year survival rate of 35.9% in the PTBD group vs 56.0% in the EBD group (p = 0.044).CONCLUSION:PTBD should be considered as a negative prognostic factor in distal cholangiocarcinoma patients.
DOI 10.1007/s10147-021-01926-8
PMID 33903992