Percutaneous radiofrequency ablation in intrahepatic cholangiocarcinoma: a retrospective single-center experience

Abstract

Background & aims: Very few data are available in literature about the role of radiofrequency ablation (RFA) in intrahepatic cholangiocarcinoma (ICC) and previous studies are mainly case reports and case series on a very small number of patients and nodules. In this study, we aimed to evaluate effectiveness and safety of RFA for the treatment of unresectable ICC. Methods: This is a retrospective observational cohort study comprising all consecutive patients treated with RFA for unresectable ICC at Policlinico Sant'Orsola Malpighi Hospital, Bologna, Italy. Primary endpoint was Local Tumor Progression-Free Survival (LTPFS) while Overall Survival (OS) was also assessed as secondary endpoint. Results: From January 2014 to June 2019, 29 patients with 117 nodules underwent RFA. Technique effectiveness 1 month after RFA was 92.3%; median LTPFS was 9.27 months. Univariate analysis and multivariate analysis showed that LTPFS was significantly related to tumor size 20 mm. At a median follow up of 39.9 months, median OS from the date of RFA was 27.5 months, with an OS of 89%, 45% and 11% at 1, 2 and 4 years, respectively. Number of overall lesions and the sum of their diameter at the moment of the first RFA significantly affected OS in multivariate analysis. Minor and major complication rates were 14% and 7%, respectively. Conclusion: Tumor size 20 mm was associated with lower LTPFS, representing a potential useful threshold value. A careful evaluation of tumor burden appears as a crucial element in choosing the best therapeutic strategy in unresectable ICC.

Phase 2 study of lenvatinib monotherapy as second-line treatment in unresectable biliary tract cancer: primary analysis results

“…Most patients were male (57.7%), had an ECOG PS score of 0 (73.1%), and had metastases of the lymph nodes (61.5%) or liver (57.7%) (Table 1 ). Additionally, the following baseline characteristics have previously demonstrated correlations with OS and/or PFS, and are shown in Table 1 according to the cutoff values used in previous research: white blood cell count, hemoglobin, alkaline phosphatase, albumin, and lesion size [ 7 , 21 ].…”

“…6 Saitama Cancer Centre, Saitama, Japan. 7 Eisai Co. Ltd., Tokyo, Japan. 8 Eisai Inc., Woodcliff Lake, NJ, USA.…”

“…Currently, radical surgery is the only potentially curative therapy, but this is not an option for many patients who present with advanced disease [ 7 ]. The standard first-line therapy for BTC is gemcitabine and cisplatin (GC) [ 4 ].…”

Circulating Tumor DNA in Biliary Tract Cancer: Current Evidence and Future Perspectives

“…Cisplatin plus gemcitabine combination chemotherapy is considered the standard firstline treatment in advanced, unresectable BTC, following the results of the ABC-02 landmark trial (25). Despite ABC-02 trial representing a historical step forward in medical treatment for advanced BTC, the survival gain provided by first-line chemotherapy is modest since nearly all patients develop progressive disease following front-line treatment, with a median overall survival (OS) of less than a year (26). More recently, although outstanding advances in genomic sequencing have given hope to new treatment strategies, BTC patients still have a poor prognosis with short life expectancy (27)(28)(29).…”

PARP Inhibitors in Biliary Tract Cancer: A New Kid on the Block?

“…Despite recent advances in the management of localized and metastatic disease, the prognosis of BTC patients remains dismal since the majority of cases are often diagnosed when unresectable or metastatic and the 5-year survival for patients with distant disease is about 5% [ 6 ]. To date, radical surgery is the only curative treatment option for BTC, but unfortunately, these malignancies are frequently asymptomatic in early stages, and approximately 40% of the patients considered resectable at the moment of diagnosis are found to be unresectable during exploratory laparotomy [ 7 , 8 ]. Systemic chemotherapy is the backbone of palliative treatment for BTC patients, with the combination of cisplatin plus gemcitabine representing the current standard of care in the front-line setting, following the results of the ABC-02 trial [ 9 ].…”