Endoscopic radiofrequency ablation for palliative treatment of hilar cholangiocarcinoma

Pereira, Pedro; Santos, Ana Luísa; Morais, Rui; Vilas-Boas, Filipe; Rodrigues‐Pinto, Eduardo; Santos-Antunes, João; Macedo, Guilherme

doi:10.1016/j.vgie.2020.12.009

Cited by 5 publications

(6 citation statements)

References 7 publications

(10 reference statements)

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“…Potential bias may arise from the type of stents used in such interventions, as a recent randomized controlled multicenter trial showed that in the case of self-expandable uncovered metallic stents RFA did not prove any positive impact on either stent patency rate or survival [ 23 ]. Efficacy might also be influenced by the location of strictures, as RFA has been of greatest interest in hilar lesions where maintaining stent patency and technical success are far more challenging [ 24 , 25 ]. Therefore, further studies comparing different devices, locations, and therapy protocols are warranted.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Endobiliary Radiofrequency Ablation in Preserving Survival, Performance Status and Chemotherapy Eligibility of Patients with Unresectable Distal Cholangiocarcinoma: A Case-Control Study

et al. 2022

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Background: Cholangiocarcinoma is the most common malignancy of the bile ducts causing intrahepatic, hilar, or distal bile duct obstruction. Most jaundiced patients are diagnosed with unresectable tumors in need for palliative bile duct drainage and chemotherapy. Endobiliary radiofrequency ablation (RFA) is an adjuvant technique that may be applied prior to biliary stenting. The aim of our study was to assess the efficacy of endobiliary RFA prior to stent insertion in patients with unresectable distal cholangiocarcinomas. Methods: Twenty-five patients (eight treated with RFA and stenting and 17 treated with stenting alone) were included in a case-controlled study. We prospectively assessed the impact of RFA on the survival rate, the patient performance status, and the preservation of eligibility for chemotherapy based on the patient laboratory profile. Results: Patients treated with RFA prior to stenting proved to have a significantly longer survival interval (19 vs. 16 months, p = 0.04, 95% CI) and significantly better performance status. Moreover, the laboratory profiles of patients treated with RFA has been proven superior in terms of total bilirubin, liver enzymes, and kidney function, thus making patients likely eligible for palliative chemotherapy. Post-ERCP adverse events were scarce in both the study group and the control group. Conclusion: Given the isolated adverse events and the impact on the patient survival, performance, and laboratory profile, RFA can be considered safe and efficient in the management of patients with unresectable distal cholangiocarcinomas.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Endobiliary Radiofrequency Ablation in Preserving Survival, Performance Status and Chemotherapy Eligibility of Patients with Unresectable Distal Cholangiocarcinoma: A Case-Control Study

et al. 2022

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“…Endoscopic RFA also appears to be an effective method for restoration of malignant biliary stent obstruction. RFA therapy alone compared to PS placement for the treatment of occluded metal stents showed a significant increase in biliary patency following RFA as well as low risk of short-term adverse events stents [96][97][98].…”

Section: Radiofrequency Ablationmentioning

confidence: 95%

Endoscopic Palliation of Gastrointestinal Disease

Chandrasekaran,

Mobin,

Gregory Brown

2024

Palliative Care - Current Practice and Future Perspectives

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Gastrointestinal malignancies account for over 35% of cancer-related deaths with a projected 73% increase by 2040. Recent advances in endoscopic technique and devices have created exponential growth in the field of therapeutic gastroenterology and have enhanced diagnostic and treatment potential. As a result, palliative endoscopic therapies have experienced an equally tremendous amount of gain. Palliative endoscopy refers to maneuvers performed during gastrointestinal procedures with the intent to minimize patient suffering and discomfort. These procedures can be highly effective in providing rapid, non-operative relief and, as such, occupy an important role in the ability to alleviate symptoms of advanced malignancies throughout the gastrointestinal tract. Complications of end-stage malignances can result in tremendous discomfort, emotional trauma, and social embarrassment for the patient. Throughout the length of the gastrointestinal tract, there are a wide variety of endoscopic procedures that can provide relief in a minimally invasive fashion. The aim of this chapter is to provide insight into the current landscape of endoscopic procedures with the intent to minimize suffering, and provide a review of the indications, practice, and outcomes of endoscopic palliative therapies available.

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“…RFA allows for tissue necrosis through thermal energy, leading to necrosis of tumor cells and good control of tumor growth. A study conducted in 2017 demonstrated increased survival in patients with advanced CC undergoing biliary drainage with stent placement associated with RFA [33].…”

Section: Palliationmentioning

confidence: 99%

Cholangiocarcinoma: A Literature Review

2024

J Dig Dis Hepatol

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Cholangiocarcinoma is a malignant neoplasm that affects the epithelium of the bile duct. It has low incidence and prevalence, usually appearing after the sixth decade of life, with a slight predominance in the male population. It mostly affects the confluence of the hepatic ducts, where it is called "hilar cholangiocarcinoma" or "Klatskin tumor". Its etiology is still partially unknown, but it has well-defined predisposing conditions and risk factors such as primary sclerosing cholangitis, parasitic infections, and exogenous toxins. The initial clinical presentation is nonspecific and can later include jaundice, weight loss, and right upper abdominal pain. Diagnosis is confirmed through clinical alterations, laboratory tests, imaging, and histopathology. Two clinical staging classifications are used: Bismuth-Corlette and TNM. The gold standard treatment is surgical excision with negative histological margins. However, the resectability rate is still low due to late diagnosis. Patients with unresectable tumors may benefit from palliative treatment, such as endoscopic stent placement or percutaneous drainage. New chemotherapy/phototherapy treatments are being studied to improve the quality of life of patients.

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Endoscopic radiofrequency ablation for palliative treatment of hilar cholangiocarcinoma

Cited by 5 publications

References 7 publications

Efficacy of Endobiliary Radiofrequency Ablation in Preserving Survival, Performance Status and Chemotherapy Eligibility of Patients with Unresectable Distal Cholangiocarcinoma: A Case-Control Study

Efficacy of Endobiliary Radiofrequency Ablation in Preserving Survival, Performance Status and Chemotherapy Eligibility of Patients with Unresectable Distal Cholangiocarcinoma: A Case-Control Study

Endoscopic Palliation of Gastrointestinal Disease

Cholangiocarcinoma: A Literature Review

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