Stent patency using competing risk model in unresectable pancreatic cancers inserted with biliary self-expandable metallic stent
Background and aim Biliary self‐expandable metallic stents (SEMS) play an important role in the quality of life and palliative treatment in unresectable pancreatic cancer patients. We aimed to determine the factors affecting the patency of biliary SEMS and the survival in unresectable pancreatic can...
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| Veröffentlicht in: | Digestive endoscopy 2013-01, Vol.25 (1), p.67-75 |
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| creator | Eum, Young Ook Kim, Yong-Tae Lee, Sang Hyub Park, Sang Wook Hwang, Jin-Hyeok Yoon, Won Jae Ryu, Ji Kon Yoon, Yong Bum Han, Joon Koo Yoon, Chang Jin Cho, Jung-Hwa Choi, Yunhee |
| description | Background and aim
Biliary self‐expandable metallic stents (SEMS) play an important role in the quality of life and palliative treatment in unresectable pancreatic cancer patients. We aimed to determine the factors affecting the patency of biliary SEMS and the survival in unresectable pancreatic cancer with obstructive jaundice.
Methods
Considering the competing risk and survival, we retrospectively evaluated the patency in 107 unresectable pancreatic cancer patients with obstructive jaundice who were successfully treated with biliary SEMS from January 2000 to April 2010.
Results
There were 107 incidents of biliary drainage that were clinically successful and the overall survival period was a median of 133 days. Stent occlusion before death was observed in 36 (33.6%) of 107 patients. Cumulative stent obstruction rates were4.7%, 16.8%, and 24.4% at 1, 3, and 6 months, respectively. Lower cancer stage ( |
| doi_str_mv | 10.1111/j.1443-1661.2012.01335.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1686432858</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1273204995</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4975-716bac5e5b827a9a77e83624890d8a76d87d9723d720515ae304dbe037a785203</originalsourceid><addsrcrecordid>eNqNkU1v1DAQhiMEotvCX0A-cknw98eBAyptKSpF4vNoOc4seOtkt3ai7t746Tjdslfqy4zk55mR5q0qRHBDynuzagjnrCZSkoZiQhtMGBPN9km1OHw8rRbYEFELycRRdZzzChfScP68OqKMakmFWVR_vo4wjGjjSvE7NOUw_EJ-3W9gnLsU8g3q1x1EFAY0DQky-NG1EYoy-ARuDB750kLKBcmQRujQXRh_ozbE4NIOZYjLGraF7-7FHkYXY9HyvPpF9WzpYoaXD_Wk-n5-9u30Q331-eLy9N1V7blRolZEts4LEK2myhmnFGgmKdcGd9op2WnVGUVZpygWRDhgmHctYKac0oJidlK93s_dpPXtBHm0fcgeYnQDrKdsidSSl7MI_X-UU6ONUeQRU6liFHNjREH1HvVpnXOCpd2k0JcDWYLtnKpd2Tk8O4dn51Ttfap2W9RXD1umtofuIP6LsQBv98BdiLB79GD7_ux67opf7_1QMtkefJdurFRMCfvz-sLSH-efPn4RxnL2F9DnwCA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1273204995</pqid></control><display><type>article</type><title>Stent patency using competing risk model in unresectable pancreatic cancers inserted with biliary self-expandable metallic stent</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Eum, Young Ook ; Kim, Yong-Tae ; Lee, Sang Hyub ; Park, Sang Wook ; Hwang, Jin-Hyeok ; Yoon, Won Jae ; Ryu, Ji Kon ; Yoon, Yong Bum ; Han, Joon Koo ; Yoon, Chang Jin ; Cho, Jung-Hwa ; Choi, Yunhee</creator><creatorcontrib>Eum, Young Ook ; Kim, Yong-Tae ; Lee, Sang Hyub ; Park, Sang Wook ; Hwang, Jin-Hyeok ; Yoon, Won Jae ; Ryu, Ji Kon ; Yoon, Yong Bum ; Han, Joon Koo ; Yoon, Chang Jin ; Cho, Jung-Hwa ; Choi, Yunhee</creatorcontrib><description>Background and aim
Biliary self‐expandable metallic stents (SEMS) play an important role in the quality of life and palliative treatment in unresectable pancreatic cancer patients. We aimed to determine the factors affecting the patency of biliary SEMS and the survival in unresectable pancreatic cancer with obstructive jaundice.
Methods
Considering the competing risk and survival, we retrospectively evaluated the patency in 107 unresectable pancreatic cancer patients with obstructive jaundice who were successfully treated with biliary SEMS from January 2000 to April 2010.
Results
There were 107 incidents of biliary drainage that were clinically successful and the overall survival period was a median of 133 days. Stent occlusion before death was observed in 36 (33.6%) of 107 patients. Cumulative stent obstruction rates were4.7%, 16.8%, and 24.4% at 1, 3, and 6 months, respectively. Lower cancer stage (<5 month's hazard ratio [HR] = 2.327, >5 month's HR = 0.108) was only associated with the longer patency of the stents in a multivariable analysis using a Fine and Gray model that considered competing risk. In multivariable analysis, lower cancer stage, uncovered stent and normalized serum bilirubin level were associated with a longer survival period (HR = 2.335, 1.906 and 1.795 respectively, P < 0.05).
Conclusion
The patency of biliary SEMS in unresectable pancreatic cancers might be affected by the stage. Lower cancer stage and normalized bilirubin are associated with longer survival.</description><identifier>ISSN: 0915-5635</identifier><identifier>EISSN: 1443-1661</identifier><identifier>DOI: 10.1111/j.1443-1661.2012.01335.x</identifier><identifier>PMID: 23286259</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Aged ; Antineoplastic Agents - therapeutic use ; bile duct ; Cancer ; Cholangiopancreatography, Endoscopic Retrograde ; Combined Modality Therapy ; Endoscopes ; Female ; Humans ; Jaundice, Obstructive - etiology ; Jaundice, Obstructive - therapy ; Male ; Metals ; Multivariable ; Palliative Care ; pancreatic cancer ; Pancreatic Neoplasms - complications ; Pancreatic Neoplasms - therapy ; Patients ; Proportional Hazards Models ; Quality of Life ; Regression Analysis ; Retrospective Studies ; Risk ; Risk Factors ; Scanning electron microscopy ; stent ; Stents ; Surgical implants ; Survival ; Survival Rate ; Treatment Outcome</subject><ispartof>Digestive endoscopy, 2013-01, Vol.25 (1), p.67-75</ispartof><rights>2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society</rights><rights>2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4975-716bac5e5b827a9a77e83624890d8a76d87d9723d720515ae304dbe037a785203</citedby><cites>FETCH-LOGICAL-c4975-716bac5e5b827a9a77e83624890d8a76d87d9723d720515ae304dbe037a785203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1443-1661.2012.01335.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1443-1661.2012.01335.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23286259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eum, Young Ook</creatorcontrib><creatorcontrib>Kim, Yong-Tae</creatorcontrib><creatorcontrib>Lee, Sang Hyub</creatorcontrib><creatorcontrib>Park, Sang Wook</creatorcontrib><creatorcontrib>Hwang, Jin-Hyeok</creatorcontrib><creatorcontrib>Yoon, Won Jae</creatorcontrib><creatorcontrib>Ryu, Ji Kon</creatorcontrib><creatorcontrib>Yoon, Yong Bum</creatorcontrib><creatorcontrib>Han, Joon Koo</creatorcontrib><creatorcontrib>Yoon, Chang Jin</creatorcontrib><creatorcontrib>Cho, Jung-Hwa</creatorcontrib><creatorcontrib>Choi, Yunhee</creatorcontrib><title>Stent patency using competing risk model in unresectable pancreatic cancers inserted with biliary self-expandable metallic stent</title><title>Digestive endoscopy</title><addtitle>Digestive Endoscopy</addtitle><description>Background and aim
Biliary self‐expandable metallic stents (SEMS) play an important role in the quality of life and palliative treatment in unresectable pancreatic cancer patients. We aimed to determine the factors affecting the patency of biliary SEMS and the survival in unresectable pancreatic cancer with obstructive jaundice.
Methods
Considering the competing risk and survival, we retrospectively evaluated the patency in 107 unresectable pancreatic cancer patients with obstructive jaundice who were successfully treated with biliary SEMS from January 2000 to April 2010.
Results
There were 107 incidents of biliary drainage that were clinically successful and the overall survival period was a median of 133 days. Stent occlusion before death was observed in 36 (33.6%) of 107 patients. Cumulative stent obstruction rates were4.7%, 16.8%, and 24.4% at 1, 3, and 6 months, respectively. Lower cancer stage (<5 month's hazard ratio [HR] = 2.327, >5 month's HR = 0.108) was only associated with the longer patency of the stents in a multivariable analysis using a Fine and Gray model that considered competing risk. In multivariable analysis, lower cancer stage, uncovered stent and normalized serum bilirubin level were associated with a longer survival period (HR = 2.335, 1.906 and 1.795 respectively, P < 0.05).
Conclusion
The patency of biliary SEMS in unresectable pancreatic cancers might be affected by the stage. Lower cancer stage and normalized bilirubin are associated with longer survival.</description><subject>Aged</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>bile duct</subject><subject>Cancer</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Combined Modality Therapy</subject><subject>Endoscopes</subject><subject>Female</subject><subject>Humans</subject><subject>Jaundice, Obstructive - etiology</subject><subject>Jaundice, Obstructive - therapy</subject><subject>Male</subject><subject>Metals</subject><subject>Multivariable</subject><subject>Palliative Care</subject><subject>pancreatic cancer</subject><subject>Pancreatic Neoplasms - complications</subject><subject>Pancreatic Neoplasms - therapy</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Quality of Life</subject><subject>Regression Analysis</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Scanning electron microscopy</subject><subject>stent</subject><subject>Stents</subject><subject>Surgical implants</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0915-5635</issn><issn>1443-1661</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1v1DAQhiMEotvCX0A-cknw98eBAyptKSpF4vNoOc4seOtkt3ai7t746Tjdslfqy4zk55mR5q0qRHBDynuzagjnrCZSkoZiQhtMGBPN9km1OHw8rRbYEFELycRRdZzzChfScP68OqKMakmFWVR_vo4wjGjjSvE7NOUw_EJ-3W9gnLsU8g3q1x1EFAY0DQky-NG1EYoy-ARuDB750kLKBcmQRujQXRh_ozbE4NIOZYjLGraF7-7FHkYXY9HyvPpF9WzpYoaXD_Wk-n5-9u30Q331-eLy9N1V7blRolZEts4LEK2myhmnFGgmKdcGd9op2WnVGUVZpygWRDhgmHctYKac0oJidlK93s_dpPXtBHm0fcgeYnQDrKdsidSSl7MI_X-UU6ONUeQRU6liFHNjREH1HvVpnXOCpd2k0JcDWYLtnKpd2Tk8O4dn51Ttfap2W9RXD1umtofuIP6LsQBv98BdiLB79GD7_ux67opf7_1QMtkefJdurFRMCfvz-sLSH-efPn4RxnL2F9DnwCA</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Eum, Young Ook</creator><creator>Kim, Yong-Tae</creator><creator>Lee, Sang Hyub</creator><creator>Park, Sang Wook</creator><creator>Hwang, Jin-Hyeok</creator><creator>Yoon, Won Jae</creator><creator>Ryu, Ji Kon</creator><creator>Yoon, Yong Bum</creator><creator>Han, Joon Koo</creator><creator>Yoon, Chang Jin</creator><creator>Cho, Jung-Hwa</creator><creator>Choi, Yunhee</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7SR</scope><scope>7TB</scope><scope>8BQ</scope><scope>8FD</scope><scope>FR3</scope><scope>JG9</scope></search><sort><creationdate>201301</creationdate><title>Stent patency using competing risk model in unresectable pancreatic cancers inserted with biliary self-expandable metallic stent</title><author>Eum, Young Ook ; Kim, Yong-Tae ; Lee, Sang Hyub ; Park, Sang Wook ; Hwang, Jin-Hyeok ; Yoon, Won Jae ; Ryu, Ji Kon ; Yoon, Yong Bum ; Han, Joon Koo ; Yoon, Chang Jin ; Cho, Jung-Hwa ; Choi, Yunhee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4975-716bac5e5b827a9a77e83624890d8a76d87d9723d720515ae304dbe037a785203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>bile duct</topic><topic>Cancer</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Combined Modality Therapy</topic><topic>Endoscopes</topic><topic>Female</topic><topic>Humans</topic><topic>Jaundice, Obstructive - etiology</topic><topic>Jaundice, Obstructive - therapy</topic><topic>Male</topic><topic>Metals</topic><topic>Multivariable</topic><topic>Palliative Care</topic><topic>pancreatic cancer</topic><topic>Pancreatic Neoplasms - complications</topic><topic>Pancreatic Neoplasms - therapy</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Quality of Life</topic><topic>Regression Analysis</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Scanning electron microscopy</topic><topic>stent</topic><topic>Stents</topic><topic>Surgical implants</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eum, Young Ook</creatorcontrib><creatorcontrib>Kim, Yong-Tae</creatorcontrib><creatorcontrib>Lee, Sang Hyub</creatorcontrib><creatorcontrib>Park, Sang Wook</creatorcontrib><creatorcontrib>Hwang, Jin-Hyeok</creatorcontrib><creatorcontrib>Yoon, Won Jae</creatorcontrib><creatorcontrib>Ryu, Ji Kon</creatorcontrib><creatorcontrib>Yoon, Yong Bum</creatorcontrib><creatorcontrib>Han, Joon Koo</creatorcontrib><creatorcontrib>Yoon, Chang Jin</creatorcontrib><creatorcontrib>Cho, Jung-Hwa</creatorcontrib><creatorcontrib>Choi, Yunhee</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Engineered Materials Abstracts</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>METADEX</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Materials Research Database</collection><jtitle>Digestive endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eum, Young Ook</au><au>Kim, Yong-Tae</au><au>Lee, Sang Hyub</au><au>Park, Sang Wook</au><au>Hwang, Jin-Hyeok</au><au>Yoon, Won Jae</au><au>Ryu, Ji Kon</au><au>Yoon, Yong Bum</au><au>Han, Joon Koo</au><au>Yoon, Chang Jin</au><au>Cho, Jung-Hwa</au><au>Choi, Yunhee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stent patency using competing risk model in unresectable pancreatic cancers inserted with biliary self-expandable metallic stent</atitle><jtitle>Digestive endoscopy</jtitle><addtitle>Digestive Endoscopy</addtitle><date>2013-01</date><risdate>2013</risdate><volume>25</volume><issue>1</issue><spage>67</spage><epage>75</epage><pages>67-75</pages><issn>0915-5635</issn><eissn>1443-1661</eissn><abstract>Background and aim
Biliary self‐expandable metallic stents (SEMS) play an important role in the quality of life and palliative treatment in unresectable pancreatic cancer patients. We aimed to determine the factors affecting the patency of biliary SEMS and the survival in unresectable pancreatic cancer with obstructive jaundice.
Methods
Considering the competing risk and survival, we retrospectively evaluated the patency in 107 unresectable pancreatic cancer patients with obstructive jaundice who were successfully treated with biliary SEMS from January 2000 to April 2010.
Results
There were 107 incidents of biliary drainage that were clinically successful and the overall survival period was a median of 133 days. Stent occlusion before death was observed in 36 (33.6%) of 107 patients. Cumulative stent obstruction rates were4.7%, 16.8%, and 24.4% at 1, 3, and 6 months, respectively. Lower cancer stage (<5 month's hazard ratio [HR] = 2.327, >5 month's HR = 0.108) was only associated with the longer patency of the stents in a multivariable analysis using a Fine and Gray model that considered competing risk. In multivariable analysis, lower cancer stage, uncovered stent and normalized serum bilirubin level were associated with a longer survival period (HR = 2.335, 1.906 and 1.795 respectively, P < 0.05).
Conclusion
The patency of biliary SEMS in unresectable pancreatic cancers might be affected by the stage. Lower cancer stage and normalized bilirubin are associated with longer survival.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>23286259</pmid><doi>10.1111/j.1443-1661.2012.01335.x</doi><tpages>9</tpages></addata></record> |
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| ispartof | Digestive endoscopy, 2013-01, Vol.25 (1), p.67-75 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Antineoplastic Agents - therapeutic use bile duct Cancer Cholangiopancreatography, Endoscopic Retrograde Combined Modality Therapy Endoscopes Female Humans Jaundice, Obstructive - etiology Jaundice, Obstructive - therapy Male Metals Multivariable Palliative Care pancreatic cancer Pancreatic Neoplasms - complications Pancreatic Neoplasms - therapy Patients Proportional Hazards Models Quality of Life Regression Analysis Retrospective Studies Risk Risk Factors Scanning electron microscopy stent Stents Surgical implants Survival Survival Rate Treatment Outcome |
| title | Stent patency using competing risk model in unresectable pancreatic cancers inserted with biliary self-expandable metallic stent |
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