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Incidence of complications associated to bile duct stents, in patients with advanced cancer: a single-center experience

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Abstract

Background

Pancreatic cancer (PCa) and biliary tract carcinomas (BTCa) have high morbidity and mortality rates. Bile duct obstruction (BDO) develops in approximately 65–75% of PCa at diagnosis, delaying the administration of optimal treatment. In patients not candidates for surgery, BDO is usually treated through the endoscopy-guided placement of self-expanding stents in the bile duct.

Methods

In this retrospective study, we sought to describe clinical characteristics and outcomes of a cohort of patients with BDO of malignant origin who underwent biliary stent placement (BSP), with a special focus regarding complications developed after the procedure. Patients with PCa, BTCa, colon cancer, lung cancer, gastric cancer, and ovarian cancer who underwent BSP from 2014 to April 2019 at our institution were included in this cohort. Demographic and clinicopathologic characteristics were collected. Statistical analysis stratified according to ECOG performance status. Specific information regarding stent material (metallic vs. plastic), as well as incidence and type of complications derived from BSP, was also recorded.

Results

One hundred fifteen patients were included. The median age was 72 years. Sixty-six patients (57%) had PCa. All patients presented hyperbilirubinemia, which decreased after the procedure in 111 (96%) patients. Complications were observed in 44 (38%) patients, most of which 33 (75%) were infections. The median time to the complication was 1 month. The mean overall survival (OS) in our study was 20.3 weeks.

Conclusion

BSP effectively decreased hyperbilirubinemia in patients with BDO; however, the procedure associated a significant rate of infectious complications, which can further compromise an effective anti-cancer therapy as well as optimal palliative strategies.

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Availability of data and material

April 2019.

Code availability

N/A.

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Funding

Dr. Servitja is a speaker bureau honoraria and has received traveling/attending symposium support from Roche, Pfizer, and MSD, as well as a speaking or advisory honoraria from Genomichealth, Daiichi-Sankyo, Astra Zeneca, Novartis.

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Author notes

  1. Alex Corbera and Alejandro Rios-Hoyo contributed equally to this manuscript.

Authors and Affiliations

  1. Medical Oncology Department, Hospital del Mar, CIBERONC, 08003, Barcelona, Spain

    Alex Corbera, Alejandro Rios-Hoyo, Laura Visa, David Casadevall & Sonia Servitja

  2. Cancer Research Program, IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), Barcelona, Spain

    Alex Corbera, Laura Visa, David Casadevall & Sonia Servitja

  3. Gastroenterology Department, Hospital del Mar, 08003, Barcelona, Spain

    Lucas Ilzarbe & Luis Barranco

  4. Radiology Department, Hospital del Mar, 08003, Barcelona, Spain

    Aleksandar Radosevic

Authors
  1. Alex Corbera
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  2. Alejandro Rios-Hoyo
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  3. Laura Visa
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  4. David Casadevall
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  5. Lucas Ilzarbe
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  6. Luis Barranco
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  7. Aleksandar Radosevic
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  8. Sonia Servitja
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Contributions

Data collector: Alex Corbera, Sonia Servitja, and Alejandro Rios-Hoyo; manuscript writers: Alejandro Rios-Hoyo, Alex Corbera, and Sonia Servitja; review data and manuscript: all authors.

Corresponding author

Correspondence to Sonia Servitja.

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All patients signed a BioBank consent form, allowing for the use of the biologic specimen, as well as clinical information for future research.

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The authors declare no competing interests.

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Corbera, A., Rios-Hoyo, A., Visa, L. et al. Incidence of complications associated to bile duct stents, in patients with advanced cancer: a single-center experience. Support Care Cancer 30, 4373–4378 (2022). https://doi.org/10.1007/s00520-021-06737-1

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  • DOI: https://doi.org/10.1007/s00520-021-06737-1

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