| セッション情報 |
シンポジウム17(消化器内視鏡学会・消化器病学会合同)
Role of oncologists and endoscopists in the management of biliary tract and pancreatic disease≪Abstract and slide：English, Presentation：Japanese≫
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| タイトル |
内S17-4：Impact of Chemotherapy on Recurrent Biliary Obstruction in Patients Receiving Covered Metallic Stent Placement for Distal Malignant Biliary Obstruction: A Retrospective Analysis of WATCH Study
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| 演者 |
Y. Nakai（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo） |
| 共同演者 |
H. Isayama（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo）, T. Mukai（Department of Gastroenterology, Gifu Municipal Hospital） |
| 抄録 |
Aim: In malignant biliary obstruction, biliary stenting is essential for chemotherapy. We reported efficacy of new Covered WallFlex stents compared with Covered Wallstents in a multicenter prospective study: WATCH study. Here we conducted a competing risk analysis of WATCH study to clarify the impact of chemotherapy on recurrent obstruction. Methods: 279 patients were included (chemotherapy 173 and BSC 106, covered WallFlex 141 and covered Wallstent 138). Rates, causes and cumulative time of recurrent obstruction were compared between chemotherapy vs. BSC. Prognostic factors for recurrent obstruction were performed using a proportional hazards model, treating death without recurrent obstruction as a competing risk. Results: The rate of recurrent obstruction (43% vs. 25%) and migration (16% vs. 7%) were significantly higher in chemotherapy compared with BSC. Cumulative incidence of recurrent obstruction was significantly higher in chemotherapy compared with BSC (P=0.030 by Gray’s test). Cumulative incidence of recurrent obstruction at 3, 6 and 12 months was 16.1 vs. 8.2%, 27.9 vs. 18.9% and 44.1 vs. 26.6% in chemotherapy vs. BSC group. The multivariate analysis revealed chemotherapy (subdistribution HR 1.93, P=0.007) as well as WallFlex stent (subdistribution HR 0.65, P=0.049) as prognostic factors for time to recurrent obstruction. Conclusion: Chemotherapy was a risk factor for recurrent obstruction in patients with distal malignant biliary obstruction who underwent covered metallic stent placement. |
| 索引用語 |
Malignant biliary obstruction, biliary stent |
