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European Radiology
Published in: European Radiology 2/2022

01-02-2022 | Cholangiocarcinoma | Interventional

Thermal ablation in the treatment of intrahepatic cholangiocarcinoma: a systematic review and meta-analysis

Authors: Gun Ha Kim, Pyeong Hwa Kim, Jin Hyoung Kim, Pyo-Nyun Kim, Hyung Jin Won, Yong Moon Shin, Sang Hyun Choi

Published in: European Radiology | Issue 2/2022

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Abstract

Objective

To summarize the efficacy and safety of thermal ablation for the treatment of intrahepatic cholangiocarcinoma (ICC).

Methods

MEDLINE, EMBASE, Cochran Library, and Web of Science databases were searched for studies reporting outcomes in patients with ICC treated with thermal ablation. Meta-analyses of cumulative overall survival (OS) and recurrence-free survival (RFS), Kaplan-Meier survival rates according to time to local tumor progression (TTLTP), technical efficacy, and incidence of complications were analyzed. Pooled hazard ratios of common variables were calculated to explore factors associated with OS.

Results

Twenty observational studies comprising 917 patients were reviewed (primary ICC [n = 502]; post-surgical recurrent ICC [n = 355]; information not available [n = 60]). The pooled proportion of technical efficacy was 91.9% (95% CI, 87.3–94.9%). The pooled 1-, 3-, and 5-year OS rates were 82.4% (95% CI, 75.1–88.9%), 42.1% (95% CI, 36.0–48.4%), and 28.5% (95% CI, 21.2–36.2%). Primary tumors showed higher 3-year OS rates than recurrent ones, with borderline significance (p = 0.072). The pooled 1- and 3-year RFS rates were 40.0% (95% CI, 33.6–46.4%) and 19.2% (95% CI, 8.4–32.7%). The pooled 1-, 3-, and 5-year TTLTP rates were 79.3% (95% CI, 65.1–90.9%), 59.5% (95% CI, 49.1–69.4%), and 58.2% (95% CI, 44.9–70.9%). The pooled incidence of major complications was 5.7% (95% CI, 4.1–7.8%). Tumor size (> 3 cm), multiple tumors, and age (> 65 years) were factors associated with shorter OS.

Conclusion

Thermal ablation is a successful alternative with a good safety profile, especially for a single ICC smaller than 3 cm.

Key Points

• The pooled 1-, 3-, and 5-year OS rates following thermal ablation for the treatment of intrahepatic cholangiocarcinoma were 82.4%, 42.1%, and 28.5%.
• The pooled incidence of major complications was 5.7%.
• A tumor size > 3 cm (HR: 2.12, p = 0.006), multiple tumors (HR: 1.67, p = 0.004), and age > 65 years (HR: 1.67, p = 0.006) were factors associated with shorter OS.
Appendix
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Metadata
Title
Thermal ablation in the treatment of intrahepatic cholangiocarcinoma: a systematic review and meta-analysis
Authors
Gun Ha Kim
Pyeong Hwa Kim
Jin Hyoung Kim
Pyo-Nyun Kim
Hyung Jin Won
Yong Moon Shin
Sang Hyun Choi
Publication date
01-02-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08216-x

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