Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Haag, GM; Herrmann, T; Jaeger, D; Stremmel, W; Schemmer, P; Sauer, P; Gotthardt, DN.
Outcomes and risk factors for cancer patients undergoing endoscopic intervention of malignant biliary obstruction.
BMC Gastroenterol. 2015; 15(3):171-171
Doi: 10.1186/s12876-015-0399-7
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- Co-authors Med Uni Graz
- Schemmer Peter
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- Abstract:
- Malignant bile duct obstruction is a common problem among cancer patients with hepatic or lymphatic metastases. Endoscopic retrograde cholangiography (ERC) with the placement of a stent is the method of choice to improve biliary flow. Only little data exist concerning the outcome of patients with malignant biliary obstruction in relationship to microbial isolates from bile. Bile samples were taken during the ERC procedure in tumor patients with biliary obstruction. Clinical data including laboratory values, tumor-specific treatment and outcome data were prospectively collected. 206 ERC interventions in 163 patients were recorded. In 43 % of the patients, systemic treatment was (re-) initiated after successful biliary drainage. A variety of bacteria and fungi was detected in the bile samples. One-year survival was significantly worse in patients from whom multiresistant pathogens were isolated than in patients, in whom other species were detected. Increased levels of inflammatory markers were associated with a poor one-year survival. The negative impact of these two factors was confirmed in multivariate analysis. In patients with pancreatic cancer, univariate analysis showed a negative impact on one-year survival in case of detection of Candida species in the bile. Multivariate analysis confirmed the negative prognostic impact of Candida in the bile in pancreatic cancer patients. Outcome in tumor patients with malignant bile obstruction is associated with the type of microbial biliary colonization. The proof of multiresistant pathogens or Candida, as well as the level of inflammation markers, have an impact on the prognosis of the underlying tumor disease.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Bile - microbiology
- Bile Duct Neoplasms - complications
- Bile Duct Neoplasms - microbiology
- Bile Duct Neoplasms - mortality
- Biomarkers, Tumor - analysis
- Biomarkers, Tumor - immunology
- Candida -
- Cholangiopancreatography, Endoscopic Retrograde -
- Cholestasis - microbiology
- Cholestasis - mortality
- Cholestasis - surgery
- Disease-Free Survival -
- Drainage - instrumentation
- Female -
- Humans -
- Male -
- Middle Aged -
- Multivariate Analysis -
- Pancreatic Neoplasms - complications
- Pancreatic Neoplasms - microbiology
- Pancreatic Neoplasms - mortality
- Prognosis -
- Prospective Studies -
- Risk Factors -
- Stents -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Cancer
- Pancreatic cancer
- Biliary obstruction
- Cholangitis
- Chemotherapy
- Systemic therapy