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Negative prognostic outcomes of percutaneous transhepatic biliary drainage in distal cholangiocarcinoma: a retrospective analysis using propensity score matching

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A Correction to this article was published on 20 July 2021

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Abstract

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.

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Acknowledgements

The authors would like to express our gratitude to Kenichiro Imai, Hideki Kajiyama, Mimi Okano, Dr. Cao Manh-Thau, and Dr. Pipit Burasakarn for providing surgical assistance.

Funding

This work was supported by the JSPS KAKENHI under Grant number 18K08632 (non-restricted educational grand).

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Authors and Affiliations

  1. Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Yutaro Matsunaga, Ryota Higuchi, Takehisa Yazawa, Shuichiro Uemura, Wataru Izumo, Takehiro Ota & Masakazu Yamamoto

  2. Department of Investigative Pathology, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aoba-ku, Sendai, 980-8575, Japan

    Toru Furukawa

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  1. Yutaro Matsunaga
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  2. Ryota Higuchi
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  3. Takehisa Yazawa
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  4. Shuichiro Uemura
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Correspondence to Ryota Higuchi.

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Supplementary Information

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Supplementary file1 (TIFF 17951 KB)

Supplementary file2 (TIFF 16870 KB)

10147_2021_1926_MOESM3_ESM.docx

Supplementary file3 (DOCX 16 KB) Supplementary Fig. 1 Kaplan-Meier curves for overall survival in patients without PBD or with PBD for distal cholangiocarcinoma

10147_2021_1926_MOESM4_ESM.docx

Supplementary file4 (DOCX 19 KB) Supplementary Fig. 2 Kaplan-Meier curves for disease-free survival after propensity score matching in patients who underwent percutaneous transhepatic biliary drainage or endoscopic biliary drainage for distal cholangiocarcinoma

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Matsunaga, Y., Higuchi, R., Yazawa, T. et al. Negative prognostic outcomes of percutaneous transhepatic biliary drainage in distal cholangiocarcinoma: a retrospective analysis using propensity score matching. Int J Clin Oncol 26, 1492–1499 (2021). https://doi.org/10.1007/s10147-021-01926-8

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  • DOI: https://doi.org/10.1007/s10147-021-01926-8

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