Impact of Radiofrequency Ablation on Malignant Biliary Strictures: Results of a Collaborative Registry
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Radiofrequency ablation of malignant biliary strictures has been offered for the last 3 years, but only limited data have been published.
To assess the safety, efficacy, and survival outcomes of patients receiving endoscopic radiofrequency ablation.
Between April 2010 and December 2013, 69 patients with unresectable neoplastic lesions and malignant biliary obstruction underwent 98 radiofrequency ablation sessions with stenting.
A total of 69 patients (22 male, aged 66.1 ± 13.3) were included in the registry. The etiology of malignant biliary stricture included unresectable cholangiocarcinoma (n = 45), pancreatic cancer (n = 19), gallbladder cancer (n = 2), gastric cancer (n = 1), and liver metastasis from colon cancer (n = 3). Seventy-eight percentage of patients had prior chemotherapy. All strictures were stented post-radiofrequency ablation with either plastic stents or metal stents. The mean stricture length treated was 14.3 mm. There was a statistically significant improvement in stricture diameter post-ablation (p < 0.0001). The likelihood of stricture improvement was significantly greater in pancreatic cancer-associated strictures [RR 1.8 (95 % 1.03–5.38)]. Seven patients (10 %) had adverse events, not linked directly to radiofrequency ablation. Median survival was 11.46 months (6.2–25 months).
Radiofrequency ablation is effective and safe in malignant biliary obstruction and seems to be associated with improved survival.
KeywordsRadiofrequency ablation Biliary obstruction Stent patency Survival Cholangiocarcinoma Pancreatic cancer
Conflict of interest
Michel Kahaleh MD has received grant support from Boston Scientific, Fujinon, EMcison, Xlumena Inc., W.L. Gore, MaunaKea, Apollo Endosurgery, Cook Endoscopy, ASPIRE Bariatrics, GI Dynamics, and MI Tech. He is a consultant for Boston Scientific and Xlumena Inc.; Amrita Sethi MD is a consultant for Boston Scientific. All other authors have no conflicts of interest to report.
- 17.National Cancer Institute. Surveillance, Epidemiology, and End Results (SEER). Bethesda, MD: National Cancer Institute; 2011. http://www.seer.cancer.gov. Accessed 7 June 2014.
- 25.Saleem A, Leggett CL, Murad MH, et al. Meta-analysis of randomized trials comparing the patency of covered and uncovered self-expandable metal stents for palliation of distal malignant bile duct obstruction. Gastrointest Endosc. 2011;74:321–327 e1–e3.Google Scholar
- 27.Hughes KS, Simon R, Songhorabodi S, et al. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Registry of hepatic metastases. Surgery. 1988;103:278–288.Google Scholar
- 32.Mihalache F, Tantau M, Diaconu B, et al. Survival and quality of life of cholangiocarcinoma patients: a prospective study over a 4 year period. J Gastrointest Liver Dis. 2010;19:285–290.Google Scholar