The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Endoluminal biliary radiofrequency ablation (RFA) has been proposed as a palliative treatment for patients with malignant biliary obstruction (MBO) in order to improve stent patency and survival. However, the existing data on patients with inoperable extrahepatic cholangiocarcinoma (eCCA) are confli...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/7/1372 |
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| author | Daniele Balducci Michele Montori Francesco Martini Marco Valvano Federico De Blasio Maria Eva Argenziano Giuseppe Tarantino Antonio Benedetti Emanuele Bendia Marco Marzioni Luca Maroni |
| author_facet | Daniele Balducci Michele Montori Francesco Martini Marco Valvano Federico De Blasio Maria Eva Argenziano Giuseppe Tarantino Antonio Benedetti Emanuele Bendia Marco Marzioni Luca Maroni |
| author_sort | Daniele Balducci |
| collection | DOAJ |
| description | Endoluminal biliary radiofrequency ablation (RFA) has been proposed as a palliative treatment for patients with malignant biliary obstruction (MBO) in order to improve stent patency and survival. However, the existing data on patients with inoperable extrahepatic cholangiocarcinoma (eCCA) are conflicting. We performed a meta-analysis of randomized trials comparing RFA plus stenting versus stenting alone in patients with inoperable eCCA. We searched for trials published in the PubMed/MEDLINE, Scopus, and Cochrane databases up to November 2023. Data extraction was conducted from published studies, and a quality assessment was carried out in accordance with the guidelines recommended by the Cochrane Collaboration. Hazard ratios (HRs) with 95% CI were estimated from the trials. The primary endpoints of interest were overall survival and stent patency. Out of 275 results, 5 randomized trials and 370 patients were included. While overall survival was not different between the groups (HR 0.62; 95% CI 0.36–1.07; <i>p</i> = 0.09; I<sup>2</sup> = 80%;), the subgroup analysis of studies employing plastic stents showed a trend toward better survival in the RFA-treated group (HR 0.42; 95% CI 0.22–0.80; <i>p</i> = 0.009; I<sup>2</sup> = 72%). Stent patency was improved in patients receiving RFA (HR 0.64; 95% CI 0.45–0.90; <i>p</i> = 0.01; I<sup>2</sup> = 23%). Adverse events were not different between the groups (OR 1.21; 95% CI 0.69–2.12; <i>p</i> = 0.50; I<sup>2</sup> = 0%). Despite the promising results, high heterogeneity and potential biases in the included studies suggest the need for further high-quality randomized trials to explore the potential cumulative effects of RFA on CCA treatment outcomes. |
| first_indexed | 2024-04-24T10:47:41Z |
| format | Article |
| id | doaj.art-51f1f17d95514c2a9daf7bc7150f5b47 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-24T10:47:41Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-51f1f17d95514c2a9daf7bc7150f5b472024-04-12T13:16:10ZengMDPI AGCancers2072-66942024-03-01167137210.3390/cancers16071372The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsDaniele Balducci0Michele Montori1Francesco Martini2Marco Valvano3Federico De Blasio4Maria Eva Argenziano5Giuseppe Tarantino6Antonio Benedetti7Emanuele Bendia8Marco Marzioni9Luca Maroni10Clinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyGastroenterology Unit, Division of Gastroenterology, Hepatology, and Nutrition, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyDivision of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, A.O.U. “Ospedali Riuniti”, 60126 Ancona, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyClinic of Gastroenterology, Hepatology, and Emergency Digestive Endoscopy, Università Politecnica delle Marche, 60126 Ancona, ItalyEndoluminal biliary radiofrequency ablation (RFA) has been proposed as a palliative treatment for patients with malignant biliary obstruction (MBO) in order to improve stent patency and survival. However, the existing data on patients with inoperable extrahepatic cholangiocarcinoma (eCCA) are conflicting. We performed a meta-analysis of randomized trials comparing RFA plus stenting versus stenting alone in patients with inoperable eCCA. We searched for trials published in the PubMed/MEDLINE, Scopus, and Cochrane databases up to November 2023. Data extraction was conducted from published studies, and a quality assessment was carried out in accordance with the guidelines recommended by the Cochrane Collaboration. Hazard ratios (HRs) with 95% CI were estimated from the trials. The primary endpoints of interest were overall survival and stent patency. Out of 275 results, 5 randomized trials and 370 patients were included. While overall survival was not different between the groups (HR 0.62; 95% CI 0.36–1.07; <i>p</i> = 0.09; I<sup>2</sup> = 80%;), the subgroup analysis of studies employing plastic stents showed a trend toward better survival in the RFA-treated group (HR 0.42; 95% CI 0.22–0.80; <i>p</i> = 0.009; I<sup>2</sup> = 72%). Stent patency was improved in patients receiving RFA (HR 0.64; 95% CI 0.45–0.90; <i>p</i> = 0.01; I<sup>2</sup> = 23%). Adverse events were not different between the groups (OR 1.21; 95% CI 0.69–2.12; <i>p</i> = 0.50; I<sup>2</sup> = 0%). Despite the promising results, high heterogeneity and potential biases in the included studies suggest the need for further high-quality randomized trials to explore the potential cumulative effects of RFA on CCA treatment outcomes.https://www.mdpi.com/2072-6694/16/7/1372radiofrequency ablationcholangiocarcinomastentingsurvivalmeta-analysis |
| spellingShingle | Daniele Balducci Michele Montori Francesco Martini Marco Valvano Federico De Blasio Maria Eva Argenziano Giuseppe Tarantino Antonio Benedetti Emanuele Bendia Marco Marzioni Luca Maroni The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Cancers radiofrequency ablation cholangiocarcinoma stenting survival meta-analysis |
| title | The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | impact of radiofrequency ablation on survival outcomes and stent patency in patients with unresectable cholangiocarcinoma a systematic review and meta analysis of randomized controlled trials |
| topic | radiofrequency ablation cholangiocarcinoma stenting survival meta-analysis |
| url | https://www.mdpi.com/2072-6694/16/7/1372 |
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