Radiofrequency ablation for the treatment of primary intrahepatic cholangiocarcinoma.
OBJECTIVE
We present the results of percutaneous radiofrequency ablation (RFA) in patients with unresectable primary intrahepatic cholangiocarcinoma.


METHODS
From 2000 to 2009, 13 patients with 17 primary intrahepatic cholangiocarcinomas underwent RFA at our institution. Intrahepatic cholangiocarcinoma was unresectable because of poor hepatic reserve due to liver cirrhosis in nine patients, extrahepatic extension in two, atrophy of the left hepatic lobe in one, and underlying comorbidities in one. Ten tumors had a diameter of less than 3 cm, five were between 3 and 5 cm, and two were larger than 5 cm. Technical effectiveness was defined as the complete ablation of the tumor, shown by imaging follow-up 1 month later. Local progression-free survival, overall survival periods, and complications after RFA were also evaluated.


RESULTS
Technical effectiveness of RFA was achieved for 15 of the 17 tumors (88%), all smaller than 5 cm in diameter. Treatment failure occurred in two patients with large tumors (7 and 8 cm). After the 17 RFA sessions, one major complication (6%), a liver abscess, occurred 1 month later. During follow-up (median, 19.5 months; range, 3.3-82.1 months), nine patients died and four remain alive. Median local progression-free survival and overall survival periods were 32.2 and 38.5 months, respectively. The 1-, 3-, and 5-year survival rates were 85%, 51%, and 15%, respectively.


CONCLUSIONS
RFA may provide successful local tumor control in patients with primary intrahepatic cholangiocarcinomas of intermediate (3-5 cm) or small (< 3 cm) diameter. RFA for unresectable primary intrahepatic cholangiocarcinoma resulted in a median overall survival period of 38.5 months.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea.
Jin Hyoung
JH
Kim
Hyung Jin
HJ
Won
Yong Moon
YM
Shin
Kyung-Ah
KA
Kim
Pyo Nyun
PN
Kim
D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008100:Liver Abscess / Q000209:etiology / Q000628:therapy; D008107:Liver Diseases / Q000209:etiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D000078702:Radiofrequency Therapy; D015996:Survival Rate; D014057:Tomography, X-Ray Computed