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经皮内镜下胆管内射频消融联合支架置入术与单纯支架置入术治疗Ⅳ型肝门部胆管癌的前瞻性对比研究。

Percutaneous endobiliary radiofrequency ablation with stent placement in type IV hilar cholangiocarcinoma: A prospective comparison with stent placement alone.

机构信息

Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

Eur J Radiol. 2024 Jul;176:111516. doi: 10.1016/j.ejrad.2024.111516. Epub 2024 May 18.

Abstract

OBJECTIVES

This study aimed to compare the safety and effectiveness of percutaneous endobiliary radiofrequency ablation with stent placement (RFA group) versus stent placement alone (stent group) in patients with type IV hilar cholangiocarcinoma.

METHODS

This prospective nonrandomized study was conducted between October 2021 and April 2023. The study included 56 participants (33 men and 23 women, median age 73 years) who underwent percutaneous endobiliary RFA with stent placement (n = 25) or stent placement alone (n = 31) for type IV hilar cholangiocarcinoma. The primary end point was stent patency, while the secondary end points were procedure-related adverse events (AE) and overall survival.

RESULTS

The percutaneous endobiliary RFA and/or stent placement were successfully completed in all patients in both groups. The median stent patency rate was higher in the RFA group than the stent group (188 days vs. 155 days, p = 0.048). There were no differences in AEs (grade 1 [5 in RFA group vs. 5 in stent group, p = 0.74] and grade 2 AEs [2 vs. 4, p = 0.68]) and patients' survival (median 222 days vs. 214 days, p = 0.49) between the two groups.

CONCLUSIONS

In patients with type IV hilar cholangiocarcinoma, percutaneous endobiliary RFA with stent placement may improve stent patency without increasing the risk of AEs compared to stent placement alone.

摘要

目的

本研究旨在比较经皮内镜下胆管内射频消融联合支架置入(RFA 组)与单纯支架置入(支架组)治疗Ⅳ型肝门部胆管癌的安全性和有效性。

方法

这是一项前瞻性非随机研究,于 2021 年 10 月至 2023 年 4 月进行。研究纳入了 56 名(男 33 例,女 23 例,中位年龄 73 岁)接受经皮内镜下胆管内 RFA 联合支架置入(n=25)或单纯支架置入(n=31)治疗Ⅳ型肝门部胆管癌的患者。主要终点为支架通畅率,次要终点为与操作相关的不良事件(AE)和总生存率。

结果

两组患者均成功完成了经皮内镜下胆管内 RFA 和/或支架置入。RFA 组的中位支架通畅率高于支架组(188 天比 155 天,p=0.048)。两组的 AE(1 级[RFA 组 5 例,支架组 5 例,p=0.74]和 2 级 AE[2 例比 4 例,p=0.68])和患者生存率(中位 222 天比 214 天,p=0.49)均无差异。

结论

与单纯支架置入相比,经皮内镜下胆管内 RFA 联合支架置入治疗Ⅳ型肝门部胆管癌可能会提高支架通畅率,且不会增加 AE 风险。

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