title: Impact of Radiofrequency Ablation on Malignant Biliary Strictures: Results of a Collaborative Registry.
abstract: BACKGROUND
  Radiofrequency ablation of malignant biliary strictures has been offered for the last 3 years, but only limited data have been published.
  
  
  OBJECTIVE
  To assess the safety, efficacy, and survival outcomes of patients receiving endoscopic radiofrequency ablation.
  
  
  METHODS
  Between April 2010 and December 2013, 69 patients with unresectable neoplastic lesions and malignant biliary obstruction underwent 98 radiofrequency ablation sessions with stenting.
  
  
  RESULTS
  A total of 69 patients (22 male, aged 66.1 ± 13.3) were included in the registry. The etiology of malignant biliary stricture included unresectable cholangiocarcinoma (n = 45), pancreatic cancer (n = 19), gallbladder cancer (n = 2), gastric cancer (n = 1), and liver metastasis from colon cancer (n = 3). Seventy-eight percentage of patients had prior chemotherapy. All strictures were stented post-radiofrequency ablation with either plastic stents or metal stents. The mean stricture length treated was 14.3 mm. There was a statistically significant improvement in stricture diameter post-ablation (p < 0.0001). The likelihood of stricture improvement was significantly greater in pancreatic cancer-associated strictures [RR 1.8 (95 % 1.03-5.38)]. Seven patients (10 %) had adverse events, not linked directly to radiofrequency ablation. Median survival was 11.46 months (6.2-25 months).
  
  
  CONCLUSIONS
  Radiofrequency ablation is effective and safe in malignant biliary obstruction and seems to be associated with improved survival.
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA.
authors.forename: Reem Z
authors.initials: RZ
authors.lastname: Sharaiha
authors.forename: Amrita
authors.initials: A
authors.lastname: Sethi
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Weaver
authors.forename: Tamas A
authors.initials: TA
authors.lastname: Gonda
authors.forename: Raj J
authors.initials: RJ
authors.lastname: Shah
authors.forename: Norio
authors.initials: N
authors.lastname: Fukami
authors.forename: Prashant
authors.initials: P
authors.lastname: Kedia
authors.forename: Nikhil A
authors.initials: NA
authors.lastname: Kumta
authors.forename: Carlos M Rondon
authors.initials: CM
authors.lastname: Clavo
authors.forename: Michael D
authors.initials: MD
authors.lastname: Saunders
authors.forename: Jorge
authors.initials: J
authors.lastname: Cerecedo-Rodriguez
authors.forename: Paola Figueroa
authors.initials: PF
authors.lastname: Barojas
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Widmer
authors.forename: Monica
authors.initials: M
authors.lastname: Gaidhane
authors.forename: William R
authors.initials: WR
authors.lastname: Brugge
authors.forename: Michel
authors.initials: M
authors.lastname: Kahaleh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications*; D017115:Catheter Ablation / Q000379:methods*; D002779:Cholestasis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011846:Radio Waves; D015607:Stents