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• W1982604695 abstract "Background: Gemcitabine (GEM) is the standard chemotherapy for unresectable pancreatic cancer. Obstructive jaundice often develops in patients with pancreatic cancer. Expandable metallic stents (EMS) are widely used to palliate unresectable malignant biliary obstructions, including pancreatic cancer. However, the efficacy and safety of EMS in patients receiving GEM for unresectable pancreatic cancer have not been evaluated. Methods: Data for 120 patients with unresectable pancreatic cancer were studied retrospectively: 52 patients received GEM without EMS, 36 patients received GEM with EMS between June 2001 and May 2006, and 32 patients received only best supportive care (BSC) with EMS between May 1995 and May 2006 at the University of Tokyo Hospital. First, overall survival and adverse effects of GEM were compared between GEM with EMS and GEM without EMS. Secondly, stent-related complications including stent occlusion were compared between GEM with EMS and BSC with EMS. Prognostic factors for survival, stent-related complications and stent patency were analyzed by the Cox proportional hazard model. The adverse effects of GEM were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: The overall incidence of adverse effects (>grade 2) caused by GEM was 17 episodes in 15 patients (28.8%) without EMS and 11 episodes in 9 patients (25.0%) with EMS (p = 0.809). Infections other than cholangitis occurred with GEM administration in 9 patients (17.3%) without EMS and 3 patients (8.3%) with EMS (p = 0.346). Cholangitis occurred exclusively in patients with EMS and was managed successfully. The median survival time was 10.1 months in the GEM with EMS Group and 10.4 months in the GEM without EMS Group (p = 0.326). Tumor extension and good performance status (PS), but not EMS, were shown to affect survival in a multivariate analysis. Stent-related complications were observed in 26 patients (72.2%) receiving GEM and in 17 patients (53.1%) with BSC (p = 0.215). Multivariate analysis revealed no predictors for stent-related complications, while the use of covered EMS and good PS were associated with longer stent patency. GEM administration affected neither stent-related complications nor stent patency. Conclusion: EMS placement was safe and effective in patients with unresectable pancreatic cancer receiving GEM." @default.
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• W1982604695 date "2007-04-01" @default.
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• W1982604695 title "Efficacy and Safety of Metallic Stents in Patients with Unresectable Pancreatic Cancer Receiving Gemcitabine" @default.
• W1982604695 doi "https://doi.org/10.1016/j.gie.2007.03.487" @default.
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