Photodynamic therapy prolongs metal stent patency in patients with unresectable hilar cholangiocarcinoma

Table 1 Patient characteristics n (%)

	PDT group (PDT with metal stenting)	Control group (metal stent only)
	(n = 18)	(n = 15)
Age, yr (range)	65.6 (44-89)	67 (53-82)
Male sex	12 (66)	12 (80)
AJCC stage1
II	3 (17)	0 (0)
IIIA/IIIB	0 (0)/6(33)	3 (20)/5 (33)
IVA/IVB	7 (39)/2 (11)	1 (7)/6 (40)
Bismuth type
II	3 (17)	4 (27)
III	5 (28)	7 (47)
IV	10 (55)	4 (27)
Lymph node metastasis	13 (72)	10 (67)
Liver metastasis	2 (11)	2 (17)
CA 19-9 (U/mL)	229 (0.9-4800)	480 (1.3-4800)
Pre-albumin (g/dL)	3.5 (2.1-4.5)	3.2 (2.0-4.3)
Bilirubin (mg/dL)
Pre-treatment	8.5 (0.6-31.9)	12.3 (0.9-26.0)
Post-treatment	1.3 (0.5-14.3)	2.9 (0.3-26.0)
Successful drainage2	15 (83)	12 (86)
Histologic confirmation	14 (78)	10 (67)
Unilateral/bilateral stenting	10 (55)/8 (45)	11 (73)/4 (27)
Early complications of procedure	3 (17)	2 (13)
Stent malfunctions	14 (78)	12 (80)
Follow-up period (median, d)	437	230

¹American Joint Committee Cancer (AJCC) staging 7th edition;

²Decrease of bilirubin to less than 50% of the pretreatment value within 7 d. Data are expressed as medians (range). PDT: Photodynamic therapy; CA: Carbohydrate antigen.

Table 2 Univariate analysis of all prognostic factors associated with stent patency and patient survival in all patients

Variables	Univariate (Kaplan-Meier and log-rank test)
	Cases	Median stent patency (d)	P value	Median patient survival (d)	P value
Age (yr)
< 65 vs≥ 65	12:21	174:206	0.524	539:290	0.103
Gender
Male vs female	24:9	193:298	0.278	322:303	0.766
CA 19-9 (U/mL)
< 100 vs≥ 100	7:26	215:177	0.308	250:317	0.145
Pre-PDT bilirubin (mg/dL)
< 3.0 vs≥ 3.0	15:18	244:181	0.112	493:250	0.026
T stage1
T1,2 vs T3,4	11:22	174:207	0.388	317:283	0.527
Number of endoprotheses
Unilateral vs bilateral	21:12	206:193	0.454	317:322	0.758
Bismuth type
II, III vs IV	19:14	206:193	0.644	283:356	0.551
PDT method
PTCS vs ERCP	11:22	200:334	0.075	322:214	0.621
Treatment group
PDT vs ERBD	18:15	244:177	0.002	356:283	0.023

¹American Joint Committee Cancer (AJCC) staging, 7th edition. PDT: Photodynamic therapy; PTCS: Percutaneous cholangioscopy; ERBD: Endoscopic retrograde biliary drainage; CA: Carbohydrate antigen; ERCP: Endoscopic retrograde cholangiopancreatography.