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Impact of endobiliary radiofrequency ablation on survival of patients with unresectable cholangiocarcinoma: a narrative review.

作者信息

Di Girolamo Elena, Belli Andrea, Ottaiano Alessandro, Granata Vincenza, Borzillo Valentina, Tarotto Luca, Tatangelo Fabiana, Palaia Raffaele, Civiletti Corrado, Piccirillo Mauro, D'Angelo Valentina, Fiore Francesco, Marone Pietro, Nasti Guglielmo, Izzo Francesco, de Bellis Mario

机构信息

Division of Gastroenterology and Gastrointestinal Endoscopy. Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy.

Division of Hepatobiliary Surgery. Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy.

出版信息

Front Oncol. 2023 May 30;13:1077794. doi: 10.3389/fonc.2023.1077794. eCollection 2023.


DOI:10.3389/fonc.2023.1077794
PMID:37324013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10266199/
Abstract

Cholangiocarcinoma (CCA) is a rare cancer originating from the biliary epithelium and accounts for about 3% of all gastrointestinal malignancies. Unfortunately, the majority of patients are not eligible for surgical resection at the time of diagnosis, because of the locally advanced stage or metastatic disease. The overall survival time of unresectable CCA is generally less than 1 year, despite current chemotherapy regimens. Biliary drainage is often required as a palliative treatment for patients with unresectable CCA. Recurrent jaundice and cholangitis tend to occur because of reobstruction of the biliary stents. This not only jeopardizes the efficacy of chemotherapy, but also causes significant morbidity and mortality. Effective control of tumor growth is crucial for prolonging stent patency and consequently patient survival. Recently, endobiliary radiofrequency ablation (ERFA) has been experimented as a treatment modality to reduce tumor mass, and delay tumor growth, extending stent patency. Ablation is accomplished by means of high-frequency alternating current which is released from the active electrode of an endobiliary probe placed in a biliary stricture. It has been shown that tumor necrosis releases intracellular particles which are highly immunogenic and activate antigen-presenting cells, enhancing local immunity directed against the tumor. This immunogenic response could potentially enhance tumor suppression and be responsible for improved survival of patients with unresectable CCA who undergo ERFA. Several studies have demonstrated that ERFA is associated with an increased median survival of approximately 6 months in patients with unresectable CCA. Furthermore, recent data support the hypothesis that ERFA could ameliorate the efficacy of chemotherapy administered to patients with unresectable CCA, without increasing the risk of complications. This narrative review discusses the results of the studies published in recent years and focuses on the impact that ERFA could have on overall survival of patients with unresectable cholangiocarcinoma.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4a1/10266199/b4756ffefca2/fonc-13-1077794-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4a1/10266199/0a921bec5e63/fonc-13-1077794-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4a1/10266199/b4756ffefca2/fonc-13-1077794-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4a1/10266199/0a921bec5e63/fonc-13-1077794-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4a1/10266199/b4756ffefca2/fonc-13-1077794-g002.jpg

相似文献

[1]
Impact of endobiliary radiofrequency ablation on survival of patients with unresectable cholangiocarcinoma: a narrative review.

Front Oncol. 2023-5-30

[2]
Endoscopic biliary treatment of unresectable cholangiocarcinoma: A meta-analysis of survival outcomes and systematic review.

World J Gastrointest Endosc. 2023-3-16

[3]
Improving biliary stent patency for malignant obstructive jaundice using endobiliary radiofrequency ablation: experience in 150 patients.

Surg Endosc. 2022-3

[4]
Impact of regular additional endobiliary radiofrequency ablation on survival of patients with advanced extrahepatic cholangiocarcinoma under systemic chemotherapy.

Sci Rep. 2022-1-19

[5]
Endobiliary radiofrequency ablation for malignant biliary obstruction.

Hepatobiliary Pancreat Dis Int. 2013-8

[6]
Endobiliary radiofrequency ablation for unresectable malignant biliary strictures: Survival benefit perspective.

Dig Endosc. 2023-7

[7]
Comparison between regular additional endobiliary radiofrequency ablation and photodynamic therapy in patients with advanced extrahepatic cholangiocarcinoma under systemic chemotherapy.

Front Oncol. 2023-8-29

[8]
Radiofrequency ablation via catheter and transpapillary access in patients with cholangiocarcinoma (ACTICCA-2 trial) - a multicenter, randomized, controlled, open-label investigator-initiated trial.

BMC Cancer. 2024-8-1

[9]
ERCP-directed radiofrequency ablation and photodynamic therapy are associated with comparable survival in the treatment of unresectable cholangiocarcinoma.

Gastrointest Endosc. 2014-11

[10]
Feasibility and safety of percutaneous transhepatic endobiliary radiofrequency ablation as an adjunct to biliary stenting in malignant biliary obstruction.

Diagn Interv Imaging. 2017-11-2

引用本文的文献

[1]
Biological functions and molecular mechanisms of circHIPK3 in digestive system tumors.

Hum Cell. 2025-5-29

[2]
Radiofrequency ablation combined with toripalimab for recurrent hepatocellular carcinoma: A prospective controlled trial.

Cancer Med. 2023-10

本文引用的文献

[1]
Endobiliary radiofrequency ablation combined with metal stents for malignant biliary obstruction due to perihilar cholangiocarcinoma (RACCOON-p): a prospective pilot study.

HPB (Oxford). 2023-9

[2]
ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures.

Am J Gastroenterol. 2023-3-1

[3]
The usefulness of endobiliary radiofrequency ablation before metal stent placement in unresectable malignant hilar obstruction.

J Gastroenterol Hepatol. 2022-11

[4]
Impact of Endoluminal Radiofrequency Ablation on Immunity in Pancreatic Cancer and Cholangiocarcinoma.

Biomedicines. 2022-6-6

[5]
Pseudoaneurysm after endoscopic biliary radiofrequency ablation for malignant biliary stricture.

J Gastrointestin Liver Dis. 2022-6-12

[6]
Impact of endobiliary radiofrequency ablation on biliary drainage in patients with malignant biliary strictures treated with uncovered self-expandable metal stents: a randomized controlled multicenter trial.

Gastrointest Endosc. 2022-12

[7]
Comparing palliative treatment options for cholangiocarcinoma: photodynamic therapy vs. radiofrequency ablation.

Clin Endosc. 2022-5

[8]
Comparison of Intraductal RFA Plus Stent versus Stent-Only Treatment for Unresectable Perihilar Cholangiocarcinoma-A Systematic Review and Meta-Analysis.

Cancers (Basel). 2022-4-21

[9]
Endobiliary Radiofrequency Ablation Combined with Gemcitabine and Cisplatin in Patients with Unresectable Extrahepatic Cholangiocarcinoma.

Curr Oncol. 2022-3-23

[10]
Cholangiocarcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry.

J Hepatol. 2022-5

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