Analysis Of Related Factors Affecting Survival Of Patients With Extrahepatic Cholangiocarcinoma After Interventional Drainage

Cholangiocarcinoma?CCA?is a highly malignant tumor with biliary epithelial differentiation.Previous studies have suggested that CCA is a rare malignant tumor,but its incidence has increased in the world in recent decades,accounting for about20%of primary liver cancer.We divided it into intrahepatic cholangiocarcinoma ?intraheptic chaolangiocarcinoma,iCCA?and extrahepatic cholangiocarciinoma ?eCCA?according to the anatomical location of CCA.The most common was eCCA,accounting for more than 90%of the total CCA.Because of the special location of eCCA,and early patients have no obvious clinical symptoms.,most patients come to see a doctor because of tumor growth leading to obstruction of the jaundice.Most of the patients are in the advanced stage and have lost the opportunity for curable resection.Studies have shown that the long-term survival rate of surgical palliative resection in patients with eCCA is not satisfactory,and eCCA is not sensitive to radiotherapy and chemotherapy,which provides room for intervention in eCCA interventional therapy.Previous studies have also reported the efficacy and advantages of various interventional approaches for the treatment of eCCA.As with other methods such as surgical resection and chemoradiotherapy,the benefits of interventional therapy for quality of life and survival of patients with eCCA are also affected by various factors such as individual differences and treatment methods.The factors affecting the survival of patients with eCCA were:preoperative bilirubin and albumin levels,tumor differentiation,radical surgery,margins,and postoperative anti-tumor therapy.Most of them are related to the factors affecting the survival of patients after surgery,and there are few studies on the factors affecting the survival of patients after intervention.In clinical work,we found that some patients who have long-term biliary drainage tube for various reasons after stent implantation have better survival status and longer survival time than patients with drainage tube removal Of course,they all need anti-tumor treatment,then.We did not find any study on the role of the retention of the drainage tube after stent implantation in interventional therapy..Therefore,we collected relevant patient data to explore the factors affecting the survival of patients with extrahepatic cholangiocarcinoma after intervention,and included the biliary stent combined with the biliary drainage tube as the influencing factors,in order to more effectively prolong the survival of patients with eCCA and improve patients.Quality of life provides new ideas.ObjectiveTo explore the effect of continuous drainage of biliary tract after interventional therapy.on the survival of patients with extrahepatic cholangiocarcinoma who cannot receive surgery.Material and methodsA total of 102 patients with extrahepatic cholangiocarcinoma,who admitted our hospital from June 2014 to January 2018,were confirmed by pathology.Retrospective analysis their demographic,pathological,laboratory,imaging,surgical and follow-up data.?1?Patients were divided into two groups according to the overall median survival time?301 days?:survival group?301 days group?group A?and>301 days group?group B?.?2?Reference factors will be used for single factor logistic regression analysis of relevant factors.Multivariate logistic regression analysis was performed on the statistically significant factors based on univariate analysis..?3?102 patients were divided into three groups:internal drainage tube placement group?group 1?,stent implantation group?group 2?,and stent combined internal drainage tube group?group 3?.The changes of TBIL,alkaline phosphatase?ALP?,ALB,liver function score and survival time were compared between the 3 groups of patients at 1 week and 1 month,and the data were statistically analyzed using SPSS21.0 version.Results?1?Stent combined with internal drainage tube,TAI/TACE combined with 125I particle cavity,ALB<30g/L is a relevant factor affecting the survival of eCCA patients.?2?The TBIL levels at 1 week and 1 month after operation were significantly lower in the 3 groups than in the preoperative group,and the difference was statistically significant?P<0.05?.The ALP levels in the 3 groups were significantly lower than those in the first week after operation?P<0.05?,but the ALP levels in the1st group were not significantly different from those in the preoperative group?P>0.05?.There was no significant difference in the ALB level between the three groups after operation?P>0.05?.The liver function of the group 3 was significantly improved after 1 month?P<0.05?.?3?There was no statistically significant difference in the changes of TBIL,ALP and 1 month after operation between the groups at 1 week after surgery and 1 month after surgery.Group 3 was compared with group 1 and group 2 in terms of liver function score in 1 month after operation.The difference was statistically significant?P=0.038 and 0.02,respectively?.The median survival time of the three groups of patients was 211.7 days,361.3days,and 468.0 days,respectively.After the Log-rank test,the median survival time difference between the three groups was statistically significant??²=11.571,P=0.003?.Conclusions?1?Stent combined with internal drainage tube,TAI/TACE combined with 125I particle cavity,ALB<30g/L is a relevant factor affecting the survival of eCCA patients.?2?Interventional surgery can effectively relieve bile duct obstruction,quickly and effectively reduce bilirubin levels and relieve obstructive jaundice.?3?The stent combined with the biliary drainage tube and the TAI/TACE+¹²⁵Iparticle cavity can effectively extend the median survival of the patient.