ABSTRACT
Objective To discuss the influence of different antitumor treatments on the survival time of patients with obstructive jaundice caused by cholangiocarcinoma located at middle-low segment of common bile duct after receiving PTCD. Methods During the period from Jan. 2012 to March 2013, a total of 60 patients with pathologically-proved cholangiocarcinoma located at the middle-low segment of common bile duct were admitted to authors’ hospital. According to tumor TNM staging, stage Ⅱ was seen in 9 cases, stage Ⅲ in 39 cases and stage Ⅳ in 12 cases. Based on the degree of cell differentiation, highly differentiated cancer was observed in 9 cases, moderately differentiated cancer in 37 cases, and poorly differentiated cancer in 14 cases. The 60 patients were enrolled in this study. Drainage tube placement and stent implantation were performed in all patients so as to relieve the symptoms of jaundice. According to the antitumor treatment used, the 60 patients were randomly and equally divided into three groups with 20 patients in each group. Draining procedure with subsequent regular arterial infusion chemotherapy was employed in the patients of group A; draining procedure with subsequent particle chain placement in biliary tract was performed in the patients of group B; and draining procedure with subsequent regular arterial infusion chemotherapy together with particle chain placement in biliary tract was carried out in the patients of group C. The results were analyzed using SPSS17.0 statistical software. The death factors of patients were statistically evaluated by using multivariate Cox proportional hazards regression analysis method, P0.05). The risk of death in group B was not significantly different from that in group A (HR=1.012, 95%CI 0.558-2.179); while the treatment mode of group C was a protection factor of death (HR=0.334, 95%CI 0.148-0.075). Conclusion The TNM stage and treatment mode can influence the survival time of patients with cholangiocarcinoma located at the middle-low segment of common bile duct. Therefore, for the treatment of obstructive jaundice caused by cholangiocarcinoma, combination use of regular arterial infusion chemotherapy and particle chain placement in biliary tract should be employed immediately after draining procedure as this therapeutic mode can effectively prolong patient’s survival time.