Tumor Biology

, Volume 35, Issue 3, pp 2753–2757 | Cite as

Efficacy of percutaneous transhepatic cholangiodrainage (PTCD) in patients with unresectable pancreatic cancer

  • Jie Wu
  • Lei Song
  • Yang Zhang
  • Dan-Yi Zhao
  • Bing Guo
  • Jing Liu
Research Article


For patients with pancreatic cancer who suffer from obstructive jaundice, percutaneous transhepatic cholangiodrainage (PTCD) is the treatment of choice. However, there are no standards for palliative care for patients undergoing this treatment. The aim of this study was to retrospectively evaluate the efficacy of post-palliative treatment in patients with unresectable pancreatic cancer who were previously treated with PTCD. The 47 patients included in this study had unresectable pancreatic cancer, presented with obstructive jaundice, had no prior history of chemotherapy, and underwent PTCD. They were divided into two groups. Group A was composed of 21 patients who received post-palliative treatment (chemotherapy, radiation, or chemoradiotherapy). Group B consisted of 26 patients who were under best supportive care (BSC). We compared the median overall survival time between the two groups to evaluate the efficacy of post-palliative treatment. The median overall survival time (MOST) of patients undergoing PTCD was 7.19 months. MOST was 9.07 months for patients in group A (P = 0.017 vs. group B) and 5.52 months for those in group B. Among the patients receiving post-palliative treatment, 12 (57 % of patients) received only a single therapy (either chemo or radiation), and 9 (43 %) received chemoradiotherapy. Their median overall survival times were 8.31 and 11.15 months, respectively (P = 0.325). Post-palliative treatment in patients with unresectable pancreatic cancer previously treated with PTCD is more effective than only best supportive care alone. Patients receiving both chemo and radiation may benefit more in terms of overall survival compared to patients receiving only one or the other.


PTCD Unresectable Pancreatic CA199 Chemoradiotherapy 


Conflict of interest



  1. 1.
    Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917.PubMedCrossRefGoogle Scholar
  2. 2.
    Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P. Pancreatic cancer: overview of descriptive epidemiology. Mol Carcinog. 2012;51:3–13.PubMedCrossRefGoogle Scholar
  3. 3.
    Sharma C, Eltawil KM, Renfrew PD, Walsh MJ, Molinari M. Advances in diagnosis, treatment and palliation of pancreatic carcinoma: 1990–2010. World J Gastroenterol. 2011;17:867–97.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Porta M, Fabregat X, Malats N, et al. Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage. Clin Transl Oncol. 2005;7:189–97.PubMedCrossRefGoogle Scholar
  5. 5.
    Sohn TA, Lillemoe KD, Cameron JL, Huang JJ, Pitt HA, Yeo CJ. Surgical palliation of unresectable periampullary adenocarcinoma in the 1990s. J Am Coll Surg. 1999;188:658–66.PubMedCrossRefGoogle Scholar
  6. 6.
    Baron TH. Expandable metal stents for the treatment of cancerous obstruction of the gastrointestinal tract. N Engl J Med. 2001;344:1681–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Tsuyuguchi T, Takada T, Miyazaki M, et al. Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas. J Hepatobiliary Pancreat Surg. 2008;15:69–73.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Carter DC. Cancer of the pancreas. Gut. 1990;31:494–6.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Kloek JJ, van der Gaag NA, Aziz Y, et al. Endoscopic and percutaneous preoperative biliary drainage in patients with suspected hilar cholangiocarcinoma. J Gastrointest Surg. 2010;14:119–25.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Kawakami H, Kuwatani M, Onodera M, et al. Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma. J Gastroenterol. 2011;46:242–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Yamagishi Y, Higuchi H, Izumiya M, et al. Gemcitabine as first-line chemotherapy in elderly patients with unresectable pancreatic carcinoma. J Gastroenterol. 2010;45:1146–54.PubMedCrossRefGoogle Scholar
  12. 12.
    Soderlund C, Linder S. Covered metal versus plastic stents for malignant common bile duct stenosis: a prospective, randomized, controlled trial. Gastrointest Endosc. 2006;63:986–95.PubMedCrossRefGoogle Scholar
  13. 13.
    Moss AC, Morris E, Mac Mathuna P. Palliative biliary stents for obstructing pancreatic carcinoma. Cochrane Database Syst Rev. 2006:CD004200.Google Scholar
  14. 14.
    Moertel CG, Frytak S, Hahn RG, et al. Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil: the Gastrointestinal Tumor Study Group. Cancer. 1981;48:1705–10.PubMedCrossRefGoogle Scholar
  15. 15.
    Safi F, Schlosser W, Kolb G, Beger HG. Diagnostic value of CA 19–9 in patients with pancreatic cancer and nonspecific gastrointestinal symptoms. J Gastrointest Surg. 1997;1:106–12.PubMedCrossRefGoogle Scholar
  16. 16.
    Kondo N, Murakami Y, Uemura K, et al. Prognostic impact of perioperative serum CA 19–9 levels in patients with resectable pancreatic cancer. Ann Surg Oncol. 2010;17:2321–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Lundin J, Roberts PJ, Kuusela P, Haglund C. The prognostic value of preoperative serum levels of CA 19–9 and CEA in patients with pancreatic cancer. Br J Cancer. 1994;69:515–9.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Micke O, Bruns F, Schafer U, Kurowski R, Horst E, Willich N. CA 19–9 in the therapy monitoring and follow-up of locally advanced cancer of the exocrine pancreas treated with radiochemotherapy. Anticancer Res. 2003;23:835–40.PubMedGoogle Scholar
  19. 19.
    Bilimoria KY, Bentrem DJ, Ko CY, et al. Validation of the 6th edition AJCC pancreatic cancer staging system: report from the National Cancer Database. Cancer. 2007;110:738–44.PubMedCrossRefGoogle Scholar

Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2013

Authors and Affiliations

  • Jie Wu
    • 1
  • Lei Song
    • 1
  • Yang Zhang
    • 1
  • Dan-Yi Zhao
    • 1
  • Bing Guo
    • 1
  • Jing Liu
    • 1
  1. 1.Department of Medical OncologyThe Second Hospital of Dalian Medical UniversityDalianChina

Personalised recommendations