Outcome of adding percutaneous transhepatic cholangial drainage to DEB-TACE in patients with unresectable cholangiocarcinoma with obstructive jaundice: comparison with sole DEB-TACE.
Jiajia Xu, Chao Chen, Yanhua Ye, Yanqiao Ren, Ke Chen, Guofeng Zhou, Chuan Cheng, Yuexiang Peng
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引用次数: 0
Abstract
Background: Intrahepatic cholangiocarcinoma (ICC) with obstructive jaundice presents a therapeutic challenge, as most patients are ineligible for surgery. While FOLFOX chemotherapy offers limited survival benefits, drug-eluting bead transarterial chemoembolization (DEB-TACE) combined with percutaneous transhepatic cholangial drainage (PTCD) may improve outcomes by addressing both tumor burden and biliary obstruction.
Objective: To evaluate the efficacy and safety of DEB-TACE + PTCD versus DEB-TACE alone in unresectable ICC patients with obstructive jaundice.
Design: Retrospective cohort study of 209 patients treated between January 2015 and November 2024.
Methods: A total of 209 patients with ICC and obstructive jaundice were included, with 95 patients in the DEB-TACE + PTCD group (D + P group) and 114 patients in the DEB-TACE alone group (DEB group). Tumor responses were evaluated at 3 months to assess treatment efficacy, while statistical analyses of adverse events were conducted to evaluate treatment safety. Kaplan-Meier method was utilized to generate survival curves. Cox analysis was performed to identify factors influencing prognosis.
Results: The median progression-free survival and OS were 6 and 14 months in D + P group and 5 and 11 months in the DEB group. The 3-month objective response rate (ORR) and disease control rate (DCR) were 36.2% and 76.6% in the D + P group. While in the DEB group, the ORR and DCR were 34.2% (p = 0.772) and 62.2% (p = 0.026). Multivariate Cox regression analysis revealed that lymph node metastasis (hazard ratio (HR) = 0.727, confidence interval (CI: 0.535-0.987), p = 0.041), level of cancer antigen (CA)-125 (HR = 0.670, CI (0.503-0.894), p = 0.006), and treatment (HR = 1.335, CI (1.002-1.780), p = 0.049) were predictors for prognosis.
Conclusion: For patients with unresectable cholangiocarcinoma complicated by obstructive jaundice, DEB-TACE following PTCD may be a safer and more effective treatment.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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