E-ISSN 1305-3612
Interventional Radiology - Original Article
Combination of intraoperative radiofrequency ablation and surgical resection for treatment of cholangiocarcinoma: feasibility and long-term survival
1 Department of Radiology, Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology, University of Ulsan College of Medicine and Asian Medical Center, Seoul, Korea  
2 Department of Radiology, University of Ulsan College of Medicine and Asian Medical Center, Seoul, Korea.  
Diagn Interv Radiol ; : -

Abstract

 

PURPOSE: Most patients with ICC are not eligible for surgical resection due to advanced stage.

To evaluate the feasibility, local tumor control, and long-term survival of intraoperative radiofrequency ablation (IORFA) with surgical resection to treat unresectable intrahepatic cholangiocarcinoma (ICC).

 

METHODS: From 2009 to 2016, 20 consecutive patients (12 primary ICC, 8 recurrent ICC) underwent curative IORFA with hepatic resection for surgically unresectable ICC. All patients were not qualified to undergo surgical resection due to multiple lesions causing postoperative hepatic insufficiency and undesirable tumor locations for surgical resection or percutaneous RFA. Among the 51 treated tumors (mean 2.6±0.9 tumors/patient), 24 were treated by IORFA and 27 were surgically removed. The technical success and efficacy, overall survival, progression-free survival (PFS), and complications were assessed retrospectively. The overall survival and PFS rates were estimated by the Kaplan-Meier method.

 

RESULTS: The technical success and efficacy of IORFA were both 100%. The overall survival rates at 6 months, 1, 3, and 5 years were 95%, 79%, 27%, and 14%, respectively. The median overall survival time was 22.0±3.45 months. The PFS rates at 6 months, 1, 3, and 5 years were 70%, 33%, 13%, and 13%, respectively. The median PFS was 9.0 ± 1.68 months. The prognosis was significantly worse for patients with recurrent ICC than for patients with primary ICC. One patient (5%) had major complications due to IORFA such as liver abscess and biliary stricture.

 

CONCLUSION: As a treatment for ICC that is not amenable to surgical resection alone, IORFA with surgical resection can be feasible and provides acceptable local tumor control and overall survival.

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