Effect of endoscopic radiofrequency ablation on the survival of patients with inoperable malignant biliary strictures: A large cohort study.

Autor: Xia MX; Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China., Wang SP; Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China., Yuan JG; Department of Gastroenterology, Third Affiliated Hospital, Second Military Medical University, Shanghai, China., Gao DJ; Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China., Ye X; Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China., Wang TT; Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China., Wu J; Department of Gastroenterology, Third Affiliated Hospital, Second Military Medical University, Shanghai, China., Zhou DX; Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China., Hu B; Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.; Department of Gastroenterology, Third Affiliated Hospital, Second Military Medical University, Shanghai, China.
Jazyk: angličtina
Zdroj: Journal of hepato-biliary-pancreatic sciences [J Hepatobiliary Pancreat Sci] 2022 Jun; Vol. 29 (6), pp. 693-702. Date of Electronic Publication: 2021 Apr 24.
DOI: 10.1002/jhbp.960
Abstrakt: 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.)
Databáze: MEDLINE
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