Minireviews
Copyright ©The Author(s) 2022.
World J Gastrointest Oncol. Jan 15, 2022; 14(1): 203-215
Published online Jan 15, 2022. doi: 10.4251/wjgo.v14.i1.203
Table 1 Utilization of radiofrequency ablation for cholangiocarcinoma
Technique
Ref.
Number of Patients
Location
Stent type
Mean number of sessions
Patency of stent (d, median)
Stent occlusion
Survival
Adverse events
Mizandari et al[78], 201339CCA (17); Bismuth I (5); II (1); IIIa (4); IV (7)-Panc CA (11), GB CA (4), HCC (1), Ampullary CA (1), Metastatic CA (5)SEMS (all)184.513 mo (median)Abdominal pain (15)
Wu et al[32], 201771[RFA and stenting = 35, stenting alone = 36]Extra-hepatic distal CCACovered SEMS (7); uncovered SEMS (28)1Uncovered SEMS (241); covered SEMS (212)-Uncovered SEMS (245 d, median); covered SEMS (278 d, median)Abdominal pain (27)
PercutaneousLi et al[29], 201526[RFA and stenting = 12, stenting alone = 14]Hilar (2), middle and distal CBD(7), Panc CA (2), ampullary CA (1)SEMS (all)1RFA group (0), control group (3)RFA group 100%; control group 85% at 90 d-Cholangitis (3)
Wu et al[31], 201547Hilar (7), distal CBD (16);ampullary CA (8); Panc CA (6); GB CA (4); HCC(2); Metastatic disease( 4)SEMS1.38149116 mo Abdominal pain (21), intra-abdominal hemorrhage (1)
Wang et al[28], 20169Bismuth IIIa (1); IIIb (1); IV (7)SEMS1 (only 1 patient had 2 sessions)100-5.3 mo Abdominal pain (3); Cholangitis (4)
Wang et al[39], 201612Bismuth I (5); IIIa (1); IV (3); Gastric CA (1); HCC(1); Congenital Choledochal cyst (1)Plastic (7); SEMs (4)1125-7.7 mo (median)Fever (2), pancreatitis (1)
Laquière et al[81], 201612Bismuth I (4); II (3); III (2); IV (3)Plastic and Metallic (does not quantify)1.63-412.3 mo Sepsis (1), early stent migration (1), late stent migration(1), cholangitis (1)
EndoscopicSharaiha et al[86], 201569Hilar (23); proximal CBD (7); distal CBD (7); Bismuth I (4); Bismuth III (2); Bismuth IV (5); Panc CA (19); GB CA (2); Gastric CA (1), Metastasis disease (3)Metallic (49); Plastic (20)1.395% at 30 d 317.7 ± 15.4 moPancreatitis (1); Cholecystitis( 2); Haemobilia (1); abdominal pain (3)
Strand et al[87], 201416Intrahepatic/proximal (1); Hilar (13); Extrahepatic/distal (2)Plastic (3); fully covered SEMS (3); uncovered SEMS (11)1.19-0.069.6 mo Stent migration (0.02); cholangitis (0.13); hepatic abscess (0.02); need for percutaneous drainage (0.01); severe abdominal pain (0.02) (occurrence per month)
Sharaiha et al[30], 201464CCA (18); Panc CA (8)Covered SEMS (8); uncovered SEMS (7); Plastic (11)1100% at 90 d 05.9 mo Abdominal pain(3); Pancreatitis (1); Cholecystitis (1)
Alis et al[88], 201310Bismuth I (4); Distal CBD (6)SEMS (all)12700-Pancreatitis (2)
Figueroa Barojas et al[49], 201320CCA (11); Panc CA (7); Gastric Ca (1), IPMN with high grade dysplasia (1)Plastic (6); covered SEMS (13); uncovered SEMS ( 1)1.25100% at 30 d 0-Abdominal pain (5); Pancreatitis (1); Cholecystitis (1)
Steel et al [19], 201121CCA (6); Panc CA (16)Uncovered SEMS (all)2114 (median stent patency at 9- d)4-Pancreatitis (1); cholecystitis (2), obstructive jaundice/death (1)
Percutaneous and endoscopicDolak et al[27], 201458Bismuth I (5); II (1); III (6); IV (33); distal CBD (5);Panc CA (4), central HCC,mCRC(3)Plastic (19); SEMS (35); no stent (4)1.44170 (Metallic stent = 218, Plastic stent = 115)-10.9 mo (median)Cholangitis (5); hemobilia (2); sepsis (2); hepatic coma (1); hepatic infarction (1)
Table 2 Utilization of Radiofrequency ablation for hepatocellular carcinoma
Ref.
Type
N
Technique
Survival
Recurrence
Adverse Events
Outcome
Zhang et al[89], 2013Retrospective155RFA (78- 93 sessions) and MWA (77-91 sessions)1-, 3-, and 5-year overall survival rates: RFA: 91.0%, 64.1% and 41.3%; MWA: 92.2%, 51.7%, and 38.5%RFA: 11/93 (11.8%) and MWA: 11/105 (10.5%)RFA group: persistent jaundice (n = 1) and biliary fistula (n = 1). MWA group: hemothorax and intrahepatic hematoma (n = 1) and peritoneal hemorrhage (n = 1)No significant differences LTP, DR, and overall survival
Karla et al[90], 2017Prospective50RFA alone (25) and RFA + alcohol ablation (25)RFA alone 84%; RFA + alcohol (80%) (at 6 month)Local recurrence (11); Distant intrahepatic tumor recurrence (4)Hemoperitoneum (1)Combined use of RFA and alcohol did not improve the local tumor control and survival
Abdelaziz et al[91], 2017Retrospective67TACE-RFA (22) and TACE-MWA (45)Survival at 1, 2 and 3 years: TACE-MWA: 83.3%, 64.7%, 64.7%; TACE-RFA: 73.1%, 40.6% and 16.2% (P = 0.08)TACE-RFA: 4 (18.2%); TACE-MWA: 8 (17.8%)TACE-RFA: bone metastases 1 (4.5%), Ascites 3 (13.6%), variceal bleeding 5 (22.7%); TACE-MWA: portal vein thrombosis: 1 (2.2%), ascites 6 (13.3%), variceal bleeding: 4 (8.9%)No significant difference in overall survival was observed
Gyori et al[92], 2017Retrospective15054% (n = 81) received TACE-based LRT, 26% (n = 39) PEI/RFA regimen, and 17% (n = 26) had no treatment while on the waiting listNo difference in overall survival after liver transplantation when comparing TACE- and RFA-based regimens. TACE- and RFA-based regimens showed equal outcomes in terms of transplantation rate, tumor response, and post-transplant survival. Lower survival in recipients of Multimodality LRT.
Hao et al[93], 2017Retrospective23750 pathologically early HCCs, 187 typical HCCsLTP observed in 1 Early HCC (2%); 46 Typical HCC (24.6%)Fever, abdominal pain and elevated liver enzyme levels. Rate of LTP for early HCCs after RFA was significantly lower than typical HCCs.
Liao et al[63], 2017Prospective randomized9648 patients wide margin (WM) ablation (≥ 10 mm) and 48 normal margin (NM) ablation (≥ 5 mm but < 10 mm )The 1-, 2-, and 3-year survival rates: WM: 95.8%, 91.6%, and 74.6%; NM: 95.8%, 78.4%, and 60.2%3-year LTP: WM: 14.9%; NM: 30.2% Intrahepatic recurrence (IHR): WM: 15.0% NM: 32.7%Perihepatic bile collection (1); intrahepatic hemorrhage(1); fever(1); liver infarction (1); thermal skin injury (1); pleural effusion (1)WM-RFA may reduce the incidence of tumor recurrence among cirrhotic patients with small HCCs
Rajyaguru et al[64], 2018Observational3980RFA (3,684) and SBRT (296)5 yr overall survival: RFA: 29.8% (95%CI: 24.5-35.3%); SBRT: 19.3% (95%CI: 13.5-25.9%)Treatment with RFA yields superior survival compared with SBRT for nonsurgically managed patients with stage I or II HCC
Parick et al[65], 2018Retrospective cohort440RFA (408) and SBRT (32)RFA patients had better overall survival (P < 0.001)SBRT (HR 1.80; 95%CI: 1.15-2.82) associated with worse survival
Santambrogio et al[94], 2018Prospective controlled264Laparoscopic hepatic resection (LHR = 59) vs laparoscopic ablation therapy (LAT = 205)Survival rates LHR at 1, 3, and 5 years were 93, 82, and 56%. In LAT = 91%, 62%, and 40% LHR = 24/59 (41%); LAT = 135/205 (66%)LAT found to be adequate alternative