01.12.2017 | Research article | Ausgabe 1/2017 Open Access

The safety and efficacy of percutaneous intraductal radiofrequency ablation in unresectable malignant biliary obstruction: A single-institution experience
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Background
Methods
Study participants
Treatment
Re-intervention
Assessment and follow-up
Statistical analysis
Results
Patient characteristics
Category
|
Subcategory
|
Number (%)
|
---|---|---|
Total
|
50
|
|
Median age(range), yr.
|
61.8(41–85)
|
|
Sex
|
||
Male
|
36(72)
|
|
Female
|
14(28)
|
|
Type of tumor
|
||
Pancreatic carcinoma
|
10(20)
|
|
Gallbladder carcinoma
|
4(8)
|
|
Cholangiocarcinoma
|
25(50)
|
|
Hepatocelluar carcinoma
|
6(12)
|
|
Lymph node metastases
|
5(10)
|
|
Level of biliary obstruction
*
|
||
Common bile or hepatic duct (type I)
|
11(22)
|
|
Type II
|
8(16)
|
|
Type III A
|
10(20)
|
|
Type III B
|
4(8)
|
|
Intrahepatic (type IV)
|
17(34)
|
|
Performance status score
|
||
0
|
10(20)
|
|
1
|
20(40)
|
|
2
|
18(36)
|
|
Previously cholangitis
|
22(44)
|
|
Distant Metastasis
|
29(58)
|
|
No. of interventions, mean (range)
|
1.2(1–3)
|
|
Subsequent chemotherapy
|
7(14)
|
Treatment details
Outcomes
Outcome
|
Number (%)
|
---|---|
Mild bleeding
|
23(46)
|
Moderate bleeding
|
4(8)
|
Mild pain
|
18(36)
|
Moderate or severe pain
|
4(8)
|
Bile infection
|
16(32)
|
Acute pancreatitis
|
0
|
Recurrent obstruction
|
|
Tumor ingrowth
|
6(12)
|
Tumor overgrowth
|
8(16)
|
Stent migration
|
1(2)
|
New stricture
|
3(6)
|
Unkown
|
1(2)
|
Univariate Analysis
|
Multivariate Analysis
|
||||
---|---|---|---|---|---|
Variable*
|
No. of cases
|
HR(95%CI)
|
P†
|
HR(95%CI)
|
P
†
|
Age(≥62 y vs < 62 y)
|
25/25
|
2.348(0.840,6.566)
|
0.104
|
||
Sex(male vs female)
|
36/14
|
1.243(0.404,3.827)
|
0.705
|
||
Tumor diagnosis (Cholangiocarcinoma vs other neoplasms)
|
25/25
|
1.770(0.679,4.612)
|
0.243
|
||
Type of obstruction(proximal vs distal)
|
19/31
|
0.899(0.324,2.494)
|
0.838
|
||
Performance status score (2 vs ≤1)
|
32/18
|
1.706(0.890,3.270)
|
0.108
|
||
Previously cholangeitis (no vs yes)
|
28/22
|
3.347(1.176,9.525)
|
0.024
|
3.347(1.176,9.525)
|
0.024
|
Distant Metastasis(yes vs no)
|
29/21
|
1.292(0.490,3.403)
|
0.605
|
||
Chemotherapy (no vs yes)
|
43/7
|
0.840(0.277,2.547)
|
0.759
|
||
TB(≥168.0 μmol/L vs <168.0 μmol/L)
|
25/25
|
0.488(0.184,1.294)
|
0.149
|
||
DB(≥95.1 μmol/L vs < 95.1 μmol/L)
|
25/25
|
0.485(0.183,1.287)
|
0.146
|
||
ALT (≥71 U/L vs <71 U/L)
|
25/25
|
1.352(0.491,3.728)
|
0.560
|
||
AST (≥72.5 U/L vs < 72.5 U/L)
|
25/25
|
0.887(0.348,2.261)
|
0.801
|
||
GGT(≥311 U/L vs < 311 U/L)
|
25/25
|
0.613(0.228,1.652)
|
0.334
|
Univariate Analysis
|
Multivariate Analysis
|
||||
---|---|---|---|---|---|
Variable*
|
No. of cases
|
HR(95%CI)
|
P†
|
HR(95%CI)
|
P
†
|
Age(≥62 y vs < 62 y)
|
25/25
|
0.776(0.379,1.589)
|
0.488
|
||
Sex(male vs female)
|
36/14
|
0.803(0.475,1.359)
|
0.414
|
||
Tumor diagnosis (Cholangiocarcinoma vs other neoplasms)
|
25/25
|
0.825(0.439,1.552)
|
0.552
|
||
Type of obstruction(proximal vs distal)
|
19/31
|
0.932(0.490,1.775)
|
0.825
|
||
Performance status score (2 vs ≤1)
|
32/18
|
1.706(0.890,3.270)
|
0.108
|
||
No. of interventions (1 vs ≥2)
|
42/8
|
0.187(0.055,0.630)
|
0.007
|
0.295(0.106,0.818)
|
0.019
|
Previously cholangeitis (no vs yes)
|
28/22
|
0.794(0.405,1.555)
|
0.500
|
||
Distant Metastasis(yes vs no)
|
29/21
|
0.897(0.474,1.698)
|
0.739
|
||
Chemotherapy (no vs yes)
|
43/7
|
0.273(0.094,0.792)
|
0.017
|
2.0.465 (0.159,1.365)
|
0.164
|
TB(≥168.0 μmol/L vs <168.0 μmol/L)
|
25/25
|
1.038(0.544,1.978)
|
0.911
|
||
DB(≥95.1 μmol/L vs < 95.1 μmol/L)
|
25/25
|
0.901(0.475,1.706)
|
0.748
|
||
ALT (≥71 U/L vs <71 U/L)
|
25/25
|
1.495(0.791,2.825)
|
0.216
|
||
AST (≥72.5 U/L vs < 72.5 U/L)
|
25/25
|
1.087(0.575,2.056)
|
0.798
|
||
GGT(≥311 U/L vs < 311 U/L)
|
25/25
|
1.100(0.584,2.072)
|
0.767
|