Thermal ablation has a sound safety profile and is a good alternative for the treatment of intrahepatic cholangiocarcinoma (ICC), especially in the case of a single tumor measuring less than 3 cm in diameter. This is according to a study by researchers from the Republic of Korea, published in the journal European Radiology.
Currently, surgical resection is the only curative treatment option for ICC. However, most patients are not candidates for resection because they are at an advanced stage of disease at the time of diagnosis. Some studies have shown thermal ablation may improve survival and slow tumor progression in ICC.
In order to summarize the efficacy and safety of the approach in ICC, the team led by Sang Hyun Choi, PhD, searched the medical literature for studies reporting outcomes in patients with ICC who were treated with thermal ablation.
They identified 20 observational studies comprising 917 patients. Of those, 502 had primary ICC, while 355 had the disease recur following surgery. There was no information available for 60 patients.
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The researchers found that the pooled 1-year overall survival rate of ICC patients treated with thermal ablation was 82.4%. This rate was reduced to 42.1% at 3 years, and 28.5% at 5 years. The 3-year overall survival was higher in patients with primary tumors compared to those with recurrent tumors. The pooled 1-year recurrence-free survival rate was 40%, while the 3-year recurrence-free survival rate was 19.2%.
Survival rates according to time to local tumor progression were 79.3% at 1 year, 59.5% at 3 years, and 58.2% at 5 years. The pooled incidence of major complications was 5.7%.
Tumors bigger than 3 cm in diameter, multiple tumors, and age higher than 65 were associated with shorter overall survival.
“Our study suggests that percutaneous thermal ablation can be a successful and safe therapeutic option in patients with ICC,” the researchers concluded.
Kim GH, Kim PH, Kim JH, et al. Thermal ablation in the treatment of intrahepatic cholangiocarcinoma: a systematic review and meta-analysis. Eur Radiol. Published online August 4, 2021. doi:10.1007/s00330-021-08216-x