Updated evidence on the clinical impact of endoscopic radiofrequency ablation in the treatment of malignant biliary obstruction

Inoue, Tadahisa; Yoneda, Masashi

doi:10.1111/den.14059

Cited by 35 publications

(37 citation statements)

References 81 publications

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“…Endobiliary radiofrequency ablation (RFA) is a promising modality that can prolong stent patency and survival in patients with eCCA [11,12] and whose application has reportedly increased worldwide in recent years. However, to the best of our knowledge, no study has investigated the combined use of endobiliary RFA and GC therapy.…”

Section: Introductionmentioning

confidence: 99%

Endobiliary Radiofrequency Ablation Combined with Gemcitabine and Cisplatin in Patients with Unresectable Extrahepatic Cholangiocarcinoma

et al. 2022

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Background: Endobiliary radiofrequency ablation (RFA) is a promising treatment modality for patients with extrahepatic cholangiocarcinoma (eCCA). However, no study has investigated the combined use of endobiliary RFA and gemcitabine plus cisplatin (GC) chemotherapy. This study aimed to examine the feasibility and efficacy of endobiliary RFA with GC therapy for patients with unresectable eCCA. Methods: The study outcomes included overall survival (OS), progression-free survival (PFS), time to recurrent biliary obstruction (RBO), and adverse events associated with the treatment. These parameters were retrospectively compared between 25 patients who underwent RFA with self-expandable metal stent (SEMS) placement followed by GC therapy (with-RFA group) and a control cohort of 25 patients who underwent SEMS placement alone and GC therapy (without-RFA group). Results: The median time to RBO was significantly longer in the with-RFA group (10.7 versus 5.2 months, p = 0.048). The median OS was significantly higher in patients with locally advanced tumors in the with-RFA group (23.1 versus 16.6 months, p = 0.032), but did not differ significantly in patients with metastasis (11.4 versus 8.5 months, p = 0.180). Similarly, the median PFS was significantly higher in the with-RFA group in patients with locally advanced disease (10.1 versus 7.3 months, p = 0.015), while there was no significant difference in patients with metastasis (5.4 versus 4.4 months, p = 0.529). The rates of various toxicities did not differ significantly between the groups. Conclusions: Endobiliary RFA prolonged the patency period of uncovered SEMS combined with GC therapy in patients with eCCA. Although RFA also yielded survival benefits, its effect was restricted to locally advanced tumors.

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Section: Introductionmentioning

confidence: 99%

Endobiliary Radiofrequency Ablation Combined with Gemcitabine and Cisplatin in Patients with Unresectable Extrahepatic Cholangiocarcinoma

et al. 2022

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“…Malignant biliary obstruction (MBO) is caused by various factors, including cholangiocarcinoma, pancreatic cancer, extrinsic compression, and adjacent inflammation. As MBO is often diagnosed at a later stage, the proportion of patients who undergo surgical resection is limited to only 30%, resulting in a high mortality rate [1][2][3][4]. Placement of a selfexpandable metal stent (SEMS) is the current standard treatment for palliation in patients with unresectable MBO [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Silver Nanofunctionalized Stent after Radiofrequency Ablation Suppresses Tissue Hyperplasia and Bacterial Growth

et al. 2022

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Intraductal radiofrequency (RF) ablation combined with placement of a self-expandable metal stent (SEMS) for malignant biliary obstruction has risks such as stent- and heat-induced biliary sludge and restenosis. Here, we investigated the efficacy of a silver nanoparticles (AgNPs)-coated SEMS to inhibit tissue hyperplasia and bacterial growth caused by RF ablation with stent placement in the rabbit bile duct. The release behavior and antibacterial effects of AgNPs-coated SEMSs were evaluated. Then, SEMSs were successfully placed in all rabbits immediately after RF ablation. Ag ions were rapidly released at the beginning and then showed a gradual release behavior. The AgNPs-coated SEMS significantly inhibited bacterial activity compared to the uncoated SEMS (p < 0.05). Cholangiography and histological examination confirmed that the level of tissue hyperplasia was significantly lower in the AgNPs group than in the control group (all p < 0.05). Immunohistochemistry analyses revealed that TUNEL-, HSP 70-, and α-SMA-positive areas were significantly lower in the AgNPs group than in the control group (all p < 0.05). Intraductal RF ablation combined with nanofunctionalized stent placement represents a promising new approach for suppressing thermal damage as well as stent-induced tissue hyperplasia and bacterial growth.

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“…Radiofrequency ablation (RFA) is a minimally invasive treatment based on alternating high-frequency electrical currents from an electrode that produces ionic agitation and generates frictional heat, thus causing coagulation necrosis [25][26][27]. In human medicine, the efficacy of RFA has been reported in several primary tumors and metastases, with improvements in the mass effect as well as controlling the biological activity of the tumor [28][29][30][31][32][33][34][35][36][37][38][39][40][41]. In veterinary medicine, percutaneous ultrasound-guided RFA has been used successfully to treat functioning parathyroid and thyroid masses in dogs [42][43][44][45] and cats [46], respectively.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs

Ochoa

Alférez²,

Blas

et al. 2021

Animals

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Chemodectomas are low prevalence tumors with complex clinical management. Many present as an incidental finding however, in other dogs, they produce pericardial effusion and/or compression, leading to the appearance of severe clinical signs. There are currently several approaches: surgery, radiotherapy, stent placement and chemotherapy. This is the first description of percutaneous echo-guided radiofrequency ablation of aortic body tumors. This minimally invasive treatment is based on high frequency alternating electrical currents from an electrode that produces ionic agitation and generates frictional heat, causing coagulation necrosis. Five dogs with an echocardiographic and cytological diagnosis of chemodectoma underwent percutaneous echo-guided radiofrequency ablation. At the time of presentation, all the dogs showed clinical signs, such as ascites and/or collapse. There were no complications either during the procedure or in the following 24 hours. Rapid clinical improvement associated with a reduction in size and change in sonographic appearance of the mass were achieved with no complications. Six months follow-up was carried out in all dogs. A second percutaneous echo-guided RFA was performed eight months after the first procedure in one dog. Based on our experience, radiofrequency ablation seems to be a feasible and safe technique, making it a potential alternative therapeutic approach in the clinical management of aortic body tumors leading to severe clinical compromise.

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Updated evidence on the clinical impact of endoscopic radiofrequency ablation in the treatment of malignant biliary obstruction

Cited by 35 publications

References 81 publications

Endobiliary Radiofrequency Ablation Combined with Gemcitabine and Cisplatin in Patients with Unresectable Extrahepatic Cholangiocarcinoma

Endobiliary Radiofrequency Ablation Combined with Gemcitabine and Cisplatin in Patients with Unresectable Extrahepatic Cholangiocarcinoma

Silver Nanofunctionalized Stent after Radiofrequency Ablation Suppresses Tissue Hyperplasia and Bacterial Growth

Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs

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