TY - JOUR T1 - Salvage PTBD With Chemotherapy Improves Survival in Patients With Unresectable Malignant Biliary Obstruction – A Single Center Retrospective Study JF - Anticancer Research JO - Anticancer Res SP - 4063 LP - 4070 DO - 10.21873/anticanres.15903 VL - 42 IS - 8 AU - DAISUKE MUROYA AU - HIROTOSHI TSURU AU - HISAAKI SHIMOKOBE AU - YUICHI NAGAO AU - YASUNORI YOSHIMOTO AU - YOSHITO WADA AU - KOUJI HAYASHI AU - SATOSHI TANIWAKI AU - RYUTA MIDORIKAWA AU - SHINICHI TANIWAKI AU - SATOKI KOJIMA AU - SHOICHIRO ARAI AU - TAKAHISA SHIRAHAMA AU - YUICHI GOTO AU - HISAMUNE SAKAI AU - MUNEHIRO YOSHITOMI AU - TORU HISAKA AU - YOSHITO AKAGI AU - KOJI OKUDA Y1 - 2022/08/01 UR - http://ar.iiarjournals.org/content/42/8/4063.abstract N2 - Background/Aim: Malignant biliary obstruction (MBO) is a life-threatening condition. We aimed to investigate the outcome of salvage percutaneous transhepatic biliary drainage (PTBD) in patients with unresectable MBO due to failure of management by endoscopic retrograde cholangiopancreatography (ERCP) and/or prior surgical bypass. Patients and Methods: Fifty-two consecutive patients (mean age, 69 years; 44.2% women) underwent salvage PTBD between 2013 and 2020. Results: The median overall survival rate was 4.2 months, with a 95% confidence interval (CI) of 1.9-5.7. The median overall survival (OS) were 11.1 months and 1.9 months for patients who underwent chemotherapy (n=17) and best supportive care (n=35), respectively (p=0.0005). Independent factors predicting poor outcome were best supportive care, with a hazard ratio (HR) of 3.3 (95%CI=1.3-8.5), American Society of Anesthesiologists physical status classification (ASA) with a HR of 13.5 (95%CI=1.3-136.0) and Eastern Cooperative Oncology Group (ECOG) performance status of 4, with a HR of 3.3 (95%CI=1.0-6.2). Conclusion: Salvage PTBD with chemotherapy has the potential to achieve prolonged survival in patients with unresectable MBO, including those with failure of ERCP and/or surgical bypass. ER -