Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

• Published in: Cardiovascular and interventional radiology Vol. 40; no. 2; pp. 260 - 269
• Main Authors: Wu, Tian-tian, Li, Wei-min, Li, Hu-cheng, Ao, Guo-kun, Zheng, Fang, Lin, Hu
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2017; Springer Nature B.V
• Subjects: ABLATION; Adult; Aged; Bile Duct Neoplasms - surgery; BILIRUBIN; Cardiology; Catheter Ablation - methods; Cholangiocarcinoma - surgery; Clinical Investigation; CLINICAL TRIALS; COMPARATIVE EVALUATIONS; CONCENTRATION RATIO; Female; Humans; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; NEOPLASMS; Nuclear Medicine; PATIENTS; Quality of Life; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOWAVE RADIATION; Retrospective Studies; SCANNING ELECTRON MICROSCOPY; Stents; THERAPY; Treatment Outcome; Ultrasound; Vascular Patency; Functional status; Stent patency; Biliary stent; Patient survival; Intraductal radiofrequency ablation; Procedure-related complications; Extrahepatic distal cholangiocarcinoma; Quality of life
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-016-1483-2

Purpose The clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA. Methods Data from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life. Results The RFA group had a longer median stent patency than the control group ( p  = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups ( p  > 0.05). Conclusions Prolongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.