Correlation between serum total bilirubin and survival in advanced cancer with obstructive jaundice after percutaneous biliary drainage

Abstract Purpose The main purpose of our study was to evaluate the impact of a decreased proportion of total serum bilirubin after percutaneous transhepatic biliary drainage (PTBD) on survival and to identify prognostic factors associated with survival in patients with malignant obstruction jaundice (MOJ). Methods From July 2010 to February 2021, 269 patients with MOJ were included. Survival time and prognostic factors were analyzed by Kaplan–Meier curves and the Cox model. The cut-off value of a decrease in the proportion of total serum bilirubin level that predicted patient mortality was determined by receiver operating characteristic (ROC) curves. Results The overall median survival time after PTBD was 135 days (min13-max1276 days-95% IC:117–153). The overall survival (OS) improved from 95 days to 243 days when the procedure achieved functional success. Multivariate analysis demonstrated that functionally successful drainage and post-drainage treatment were independent positive prognostic factors, but the total bilirubin after drainage and tumor size were independent negative predictive values. The cut-off value of the proportional decrease in the total serum bilirubin level for predicting the clinical prognosis was 0.44. Conclusions Palliative care after drainage can prolong patient survival and improve their quality of life. A decreased proportion of total serum bilirubin after PTBD could be used to predict the survival prognosis in patients.