Abstract 296P
Background
Unresectable malignant biliary obstruction confers a poor prognosis. Drainage of the biliary system with percutaneous trans-hepatic biliary drainage (PTBD) is offered with the intent of palliation of symptoms or to enable SACT (systemic anti-cancer treatment) but is associated with significant morbidity and mortality. Repeat PTBD for oncology patients was reviewed, asessing factors associated with poor outcomes to improve patient selection for PTBD.
Methods
Retrospective study of patients undergoing repeat PTBD at University Hospital Coventry & Warwickshire between 2015-2020. By collating data from the hospital database, morbidity and mortality of a repeat PTBD was reviewed, and factors associated with increased mortality noted.
Results
27 cases of repeat PTBD for recurrent malignant biliary obstruction were identified and analysed out of a total of 211 PTBD procedures performed for malignant biliary obstruction. Median survival was 81 days (range 22-455), median length of stay 15 days (range 2-52), and median age 66 (range 34-81). Mortality: in hospital was 3.7%, 7 day 0%, 30 day 7.4% and 90 day 48%. Factors associated with lower median survival rates were: male gender, age > 65, receiving SACT (either before or after PTBD), complications of post procedure sepsis and a pre-procedure bilirubin of greater than 100 umols/L. Patients receiving SACT within 3 months prior to PTBD had better median survival compared to those who had SACT > 3 months prior (90 days vs 72). SACT following PTBD had the highest median survival (278 days). Comparatively, cases receiving no chemotherapy (pre or post PTBD) had the lowest median survival (69 days) Table: 296P
Median survival following PTBD (days)
Female | Male |
110 | 68 |
Age <65 | Age 65+ |
96 | 81 |
SACT | No SACT |
91 | 69 |
No sepsis | Sepsis |
103 | 75 |
Bilirubin <100umol/L | Bilirubin >100umol/L |
96 | 83 |
Post procedure sepsis reduced median survival and increased median length of stay from 10 to 17 days.
Conclusions
Repeat PTBD in this cohort of patients showed a similar median survival to those undergoing first episode of PTBD (81 vs 88 days respectively). Features associated with better outcomes that could potentially guide patient selection include: lower age, female gender, lower bilirubin pre-procedure and being on active SACT or progressing to SACT post procedure.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
393P - Clinical characteristics and prognosis of patients with pulmonary mucoepidermoid carcinoma: A SEER-based analysis
Presenter: Lingxiao Qiu
Session: e-Poster Display Session
394P - Apatinib plus etoposide capsules as third-line or further-line treatment for extensive stage small cell lung cancer patients: A multicenter, single arm, phase II clinical trial
Presenter: Zhen He
Session: e-Poster Display Session
395P - Afatinib in Asian and non-Asian patients (pts) with EGFR mutation positive (EGFRm+) NSCLC harboring major uncommon mutations
Presenter: James Chih-Hsin Yang
Session: e-Poster Display Session
396P - Efficacy and safety of S-1 in elderly patients with advanced non-small cell lung cancer previously treated with platinum-based chemotherapy: A subgroup analysis of the EAST-LC
Presenter: James Chih-Hsin Yang
Session: e-Poster Display Session
397P - A phase I cohort expansion trial of OBI-833 in non-small cell lung cancer patients
Presenter: Ching-Liang Ho
Session: e-Poster Display Session
398P - Real-world mechanism of crizotinib-resistance in MET exon 14 skipping mutations non-small-cell lung cancer using next generation sequencing: A multicenter study
Presenter: Dong Wang
Session: e-Poster Display Session
399P - Real-world insights into patients (pts) with advanced NSCLC and MET alterations
Presenter: Marisa Bittoni
Session: e-Poster Display Session
400P - Sequential afatinib and osimertinib in real-world EGFR mutation positive (EGFRm+) NSCLC: Final analysis of Asian patients in the GioTag study
Presenter: Maximilian J. Hochmair
Session: e-Poster Display Session
401P - A prospective, phase II trial of low-dose afatinib monotherapy for patients with EGFR, mutation-positive, non-small cell lung cancer (TORG1632)
Presenter: Satoshi Igawa
Session: e-Poster Display Session
402P - Efficacy and safety of sintilimab plus docetaxel in patients with previously treated advanced non-small cell lung cancer (NSCLC)
Presenter: Zhehai Wang
Session: e-Poster Display Session