1. Effect of endoscopic radiofrequency ablation on the survival of patients with inoperable malignant biliary strictures: A large cohort study.
- Author
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Xia MX, Wang SP, Yuan JG, Gao DJ, Ye X, Wang TT, Wu J, Zhou DX, and Hu B
- Subjects
- Bile Ducts, Intrahepatic surgery, Cholangiopancreatography, Endoscopic Retrograde methods, Cohort Studies, Constriction, Pathologic surgery, Humans, Treatment Outcome, Bile Duct Neoplasms complications, Bile Duct Neoplasms surgery, Catheter Ablation adverse effects, Cholangiocarcinoma surgery, Cholestasis diagnostic imaging, Cholestasis etiology, Cholestasis surgery, Radiofrequency Ablation
- Abstract
Background and Aims: Endoscopic radiofrequency ablation (RFA) is an emerging technique for the palliation of inoperable malignant biliary strictures (MBSs). We aimed to systemically investigate the long-term outcome of RFA in a large cohort of patients., Methods: We recruited 883 patients with various MBSs who underwent endoscopic interventions at two large-volume centers; 124 patients underwent RFA and stenting, whereas 759 underwent stenting alone. To overcome selection bias, we performed 1:4 propensity score matching (PSM). The main outcome was overall survival (OS)., Results: Following PSM, patients in the RFA group showed significantly longer OS (9.5 months; 95% CI: 7.7-11.3 months) than those in the stenting alone group (6.1 months; 95% CI: 5.6-6.6 months; P < .001). In stratified analyses, the improved OS was only demonstrated in the subgroup of extrahepatic cholangiocarcinoma (11.3 months 95% CI: 10.2-12.4 vs 6.9 months 95% CI: 6.0-7.8; P < .001), but not in the subgroups of gallbladder cancer, hepatocellular carcinoma, intrahepatic cholangiocarcinoma, pancreatic cancer, and other metastatic cancers (all P > .05). The survival benefits were noted only in the patients with non-metastatic cholangiocarcinoma (11.5 vs 7.4 months, P < .001)., Conclusions: The survival benefits of endoscopic RFA appear to be limited to patients with extrahepatic cholangiocarcinoma without distant metastasis., (© 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)
- Published
- 2022
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