Endoscopic radiofrequency ablation plus plastic stent placement versus stent placement alone for unresectable extrahepatic biliary cancer: a multicenter randomized controlled trial

A review of the recent advances in endoscopic retrograde cholangiography-guided intraductal radiofrequency ablation for malignant biliary strictures

“…Over the past decade, many studies have validated the technical safety and effectiveness of ID-RFA (Table 1). [14][15][16][17][18][19][20][22][23][24][25][26][27][28][29][30][31][32][33] Most studies used the Habib RFA catheter, and various biliary stents were placed to maintain biliary drainage after ID-RFA. Alis et al 24 reported that endobiliary RFA therapy is feasible and safe for palliative treatment of distal and bismuth type I hilar extrahepatic cholangiocarcinoma.…”

“…To address these conflicting results, additional large-scale randomised studies have recently been conducted. Gao et al 31 compared the efficacy and safety between the RFA + stent group and the stent-only group in patients with unresectable malignant biliary obstruction, such as those with cholangiocarcinoma and ampullary cancer: 174 participants were randomly assigned in a 1 : 1 ratio and completed the two scheduled ERCPs with an interval of approximately 3 months. Median overall survival was significantly higher in the RFA group (14.3 vs 9.2 months; hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.35-0.68; P < 0.001).…”

“…20 In particular, because ELRA has four different lengths-the shortest being 11 mm-it is expected to be safer for hilar ID-RFA compared with the 24-mm Habib RFA catheter. Although various treatment results for ID-RFA have been reported for perihilar lesions, 30,31 because sufficient evidence has not yet been accumulated, more well-designed clinical studies are needed to clarify whether ID-RFA could extend stent patency and improve survival in those with malignant perihilar biliary strictures.…”

Endoscopic radiofrequency ablation to prolong survival for unresectable extrahepatic biliary cancer

“…As such, endoscopic drainage is associated with a lower complication rate than is surgical decompression. 1 In this issue of Gastrointestinal Endoscopy, Gao et al 2 report a randomized controlled trial on the added value of endoscopic radiofrequency ablation (RFA) in combination with stent placement for malignant extrahepatic obstruction. The authors conclude that additional RFA may improve overall survival and quality of life in patients with inoperable extrahepatic cholangiocarcinoma or ampullary carcinoma.…”

Intraductal Radiofrequency Ablation for Residual Adenoma after Endoscopic Papillectomy: An Additional Treatment Modality Expected to Be Safe and Effective

“…The effectiveness of RFA has been demonstrated in a recent large-scale randomized controlled trial. Gao et al 10 compared the efficacy and safety between the RFA+ stent group and the stent-only group in patients with unresectable malignant biliary obstruction, such as those with cholangiocarcinoma and ampullary cancer; 174 participants were randomly assigned in a 1:1 ratio and completed the two scheduled ERCPs with an interval of approximately 3 months. The median overall survival was significantly higher in the RFA group (14.3 months vs 9.2 months; hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.35 to 0.68; p<0.001).…”