Long-term follow-up of a randomized trial of biliary drainage in perihilar cholangiocarcinoma

Autor: Lynn E. Nooijen, Stijn Franssen, Carlijn I. Buis, Cornelis H.C. Dejong, Marcel den Dulk, Otto M. van Delden, Jan N. Ijzermans, Bas Groot Koerkamp, Geert Kazemier, Krijn van Lienden, Heinz-Josef Klümpen, Hendrien Kuipers, Bram Olij, Robert J. Porte, Erik A. Rauws, Rogier P. Voermans, Thomas M. van Gulik, Joris I. Erdmann, E. Roos, R.J. Coelen
Přispěvatelé: Radiology and nuclear medicine, Surgery, CCA - Cancer Treatment and quality of life, CCA - Cancer biology and immunology, Internal medicine, Oncology, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, CCA - Cancer Treatment and Quality of Life, Gastroenterology and Hepatology, Groningen Institute for Organ Transplantation (GIOT), RS: NUTRIM - R2 - Liver and digestive health, MUMC+: MA Heelkunde (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: HPB. John Wiley and Sons Inc.
HPB, 25(2), 210-217. John Wiley & Sons Inc.
Hpb, 25(2), 210-217. ELSEVIER SCI LTD
HPB, 25(2), 210-217. ELSEVIER SCI LTD
Nooijen, L E, Franssen, S, Buis, C I, Dejong, C H C, den Dulk, M, van Delden, O M, Ijzermans, J N, Groot Koerkamp, B, Kazemier, G, van Lienden, K, Klümpen, H-J, Kuipers, H, Olij, B, Porte, R J, Rauws, E A, Voermans, R P, van Gulik, T M, Erdmann, J I, Roos, E & Coelen, R J 2022, ' Long-term follow-up of a randomized trial of biliary drainage in perihilar cholangiocarcinoma ', HPB . https://doi.org/10.1016/j.hpb.2022.10.009
ISSN: 1365-182X
DOI: 10.1016/j.hpb.2022.10.009
Popis: BACKGROUND AND AIMS: The DRAINAGE trial was a randomized controlled trial comparing preoperative endoscopic (EBD) and percutaneous biliary drainage (PTBD) in patients with potentially resectable, perihilar cholangiocarcinoma (pCCA). The aim of this study was to compare the long-term outcomes.METHODS: Patients were randomized in four tertiary referral centers. Follow-up data were available for all included patients. Primary outcome was overall survival (OS). Secondary outcomes were readmissions, and re-interventions not including in-trial interventions.RESULTS: A total of 54 patients were randomized; 27 in both groups. Median follow-up for both groups was 62 months (95% CI 54-70). The median OS was 13 months (95% CI 7.9-18.1) in the EBD and 7 months (95% CI 0.0-17.2) in the PTBD group (P = 0.28). Twenty (37%, n = 8 EBD vs n = 12 PTBD, P = 0.43) of 54 patients were readmitted at least once, mostly due to drainage-related complications (n = 13, 24%). Of note, 14 out of the 54 patients died within the trial. A total of 76 drainage procedures (32 EBD and 44 PTBD) were performed in 28 patients. The median number of stent or drain placements was 2 (2-4) for the EBD group and 2 (1-3) for the PTBD group (P = 0.77).DISCUSSION: Although this follow-up study represented a small cohort, no long-term differences in survival, readmissions, and drainage procedures for EBD and PTBD were found, even when comparing the resected and unresected group. However, this study demonstrates the complexity of biliary drainage for patients with potentially resectable pCCA, even in tertiary referral centers.
Databáze: OpenAIRE
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