Radiofrequency ablation may benefit inoperable intrahepatic cholangiocarcinoma

  • Wu L & al.
  • J Surg Oncol
  • 15 oct. 2019

  • de Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Radiofrequency ablation (RFA) is associated with better outcomes than chemotherapy or radiotherapy in nonoperable intrahepatic cholangiocarcinoma.

Why this matters

  • Small, single-institution studies had suggested efficacy for RFA, but the level of evidence was low because of patient heterogeneity, small sample sizes, or poor study design.

Study design

  • Analysis of patients identified from the National Cancer Database (n=505; 86 RFA, 419 chemotherapy/radiotherapy).
  • Propensity score-matched analysis (84 RFA, 84 chemotherapy/radiotherapy).
  • Funding: None disclosed.

Key results

  • Those who underwent RFA were more likely to have Charlson‐Deyo comorbidity scores ≥1 (55.8% vs 37.0%; P=.001), have stage I disease (65.1% vs 52.0%; P=.03), and undergo treatment at an academic facility (70.9% vs 56.8%; P=.02).
  • Median follow-up, 12.3 months.
  • 5-year OS was higher in the RFA group (17.1% vs 6.3%; P<.001 overall as well in the propensity-matched analysis vs p>
  • A bivariate analysis showed RFA was associated with improved OS (HR, 0.46; P<.001>
  • Subanalyses:
    • Stage I: 5-year OS, 20.1% vs 3.7% (P<.001>
    • Stage II: 3-year OS, 27.2% vs 12.2% (P=.18).

Limitations

  • Retrospective analysis.