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. Aim: 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). Conclusion: Radiofrequency ablation is effective and safe in malignant biliary obstruction and seems to be associated with improved survival.