title: Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life.
abstract: OBJECTIVE
  The clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.
  
  
  METHODS
  Data from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.
  
  
  RESULTS
  The RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).
  
  
  CONCLUSIONS
  Prolongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.
authors.affiliation: Hepatobiliary Surgery Department, The 309th Hospital of PLA, Beijing, 100091, China. matthewwu1979@hotmail.com.
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Wu
authors.affiliation: Hepatobiliary Surgery Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Li
authors.affiliation: General Surgery Department, The 307th Hospital of PLA, Beijing, 100071, China.
authors.forename: Hu-Cheng
authors.initials: HC
authors.lastname: Li
authors.affiliation: Radiology Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Guo-Kun
authors.initials: GK
authors.lastname: Ao
authors.affiliation: Hepatobiliary Surgery Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zheng
authors.affiliation: Radiology Department, The 309th Hospital of PLA, Beijing, 100091, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D018281:Cholangiocarcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: Biliary stent; Extrahepatic distal cholangiocarcinoma; Functional status; Intraductal radiofrequency ablation; Patient survival; Procedure-related complications; Quality of life; Stent patency