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Potential survival benefit of radiofrequency ablation for small solitary intrahepatic cholangiocarcinoma in nonsurgically managed patients: A population‐based analysis
Author(s) -
Wu Lu,
Tsilimigras Diamantis I.,
Farooq Ayesha,
Hyer J. Madison,
Merath Katiuscha,
Paredes Anghela Z.,
Mehta Rittal,
Sahara Kota,
Shen Feng,
Pawlik Timothy M.
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25736
Subject(s) - medicine , propensity score matching , hazard ratio , chemoradiotherapy , radiofrequency ablation , intrahepatic cholangiocarcinoma , stage (stratigraphy) , confidence interval , subgroup analysis , population , surgery , cohort , gastroenterology , cancer , ablation , paleontology , environmental health , biology
Background Little data regarding the selection of nonsurgical therapies for localized intrahepatic cholangiocarcinoma (ICC) are available. Methods A cohort of nonsurgically managed patients with American Joint Commission on Cancer clinical stage I/II ICC in the United States from 2004 to 2013 were identified in the National Cancer Database. Overall survival (OS) was compared according to treatment options (radiofrequency ablation [RFA] vs chemoradiotherapy) using propensity‐score matching. Results Among 505 patients, 86 patients were treated with RFA and 419 patients were treated with chemoradiotherapy. After propensity matching (n = 84, each group), 5‐year OS was 17.6% among patients who underwent RFA vs 3.8% among patients receiving chemoradiotherapy ( P < .001). On bivariate analysis, RFA was related to an OS benefit (hazard ratio, 0.46; 95% confidence interval, 0.33‐0.66; P < .001). Specifially, a stage‐specific subgroup analysis revealed a survival benefit in favor of RFA among stage I patients (5‐year OS; RFA: 20.1% vs chemoradiotherapy: 3.7%, P < .001 ) , whereas no difference in OS was noted among patients with stage II disease. Conclusion Among ICC patients with small (≤5 cm), solitary ICC without vascular invasion, RFA was associated with better survival compared with chemoradiotherapy.