TITLE:
Metal Stenting with or without Endobiliary Radiofrequency Ablation for Unresectable Extrahepatic Cholangiocarcinoma
AUTHORS:
Huihong Liang, Zhenwei Peng, Liangqi Cao, Shikun Qian, Zili Shao
KEYWORDS:
Cholangiocarcinoma, Endoscopic Retrograde Cholangiopancreatography, Percutaneous Transhepatic Cholangiography, Radiofrequency Ablation, Survival
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.11,
October
16,
2015
ABSTRACT: Background: Retrospective comparison of stent patency and survival of
patients with unresectable extrahepatic cholangiocarcinoma (CCA) treated by
placement of self-expanding metal stents (SEMS) with or without endobiliary
radiofrequency ablation (ERFA). Methods: Between January 2010 and September
2014, 76 patients with biliary obstruction caused by unresectable extrahepatic
CCA (27 patients with Bismuth type I hilar CCA and 49 patients with distal CCA)
were recruited into this study. Patients either received ERFA with SEMS (n =
34) or SEMS only (n = 42). Stent patency and survival of both groups were
compared and predictors for overall survival were analyzed. Results:
Demographic data were not different between the two groups. Complication rates
of both groups were similar. Thirty-day stent patency was obtained in all
patients and the median stent patency in the ERFA + SEMS group (9.5 months, 4.5
- 14.0 months) was significantly longer than that in the SEMS group (8.4
months, 4.9 - 11 months) (P = 0.024). The overall survival curve in the ERFA + SEMS
group was significantly better than that of the SEMS group (P = 0.036). Multivariate Cox proportional hazards
regression analyses showed that ERFA, tumor AJCC stage, extrahepatic CCA type,
serum albumin and adjuvant chemotherapy were significant prognostic factors for
overall patient survival. Conclusions: ERFA is effective for unresectable
extrahepatic CCA and may improve metal stent
patency and patient survival for unresectable extrahepatic CCA with biliary
obstruction. Prospective randomized trials will be needed to confirm these
findings.