Survival impact of pancreatic stenting in unresected pancreatic head cancer with obstructive jaundice: a retrospective cohort study.

BACKGROUND

Malnutrition is common in patients with pancreatic head cancer, which can diminish their tolerance to anti-cancer treatments. Pancreatic duct blockage is one of the contributing factors leading to malnutrition.

OBJECTIVES

This study aimed to clarify whether pancreatic stenting offers a survival benefit in patients with unresected pancreatic head cancer.

DESIGN

Retrospective observational study.

METHODS

Patients with newly diagnosed pancreatic cancers who received endoscopic retrograde cholangiopancreatography (ERCP) because of biliary tract obstruction were collected from a hospital-based cancer registry between 2007 and 2021. Individuals who underwent tumor resection or bypass surgery following ERCP were excluded. The primary outcome was the 1-year survival rate in patients with and without a pancreatic stent. Secondary outcomes included overall survival, cancer-specific survival, and changes in weight and nutritional markers following ERCP.

RESULTS

Among 562 patients, 39 (6.9%) received pancreatic stent placement. Most of the patients (90%) did not receive tumor resection because of advanced-stage disease. The stent group had a lower 1-year survival rate than the non-stent group (18% vs 30%; p = 0.047). The median survival time appeared to be shorter in the stent group (170 vs 217 days; p = 0.077). The adjusted hazard ratio of pancreatic stent placement was 1.42 (95% confidence interval, 0.75-2.67; p = 0.282). In addition, changes in weight and nutritional markers after ERCP did not differ significantly between the groups.

CONCLUSION

Pancreatic stent placement in unresected pancreatic head cancer with obstructive jaundice does not improve survival or nutritional status.