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Ablative therapy for unresectable intrahepatic cholangiocarcinoma: A systematic review and meta-analysis

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Title: Ablative therapy for unresectable intrahepatic cholangiocarcinoma: A systematic review and meta-analysis
Authors: Youssaf, A
Kim, J
Eliahoo, J
Taylor-Robinson, S
Khan, S
Item Type: Journal Article
Abstract: Background: Intrahepatic cholangiocarcinoma (iCCA) is usually a fatal malignancy with rising incidence globally. Surgical resection currently remains the only curative treatment. However, as only a minority of iCCA are amenable to resection, new therapeutic modalities are needed. Aims: Our aims were to systematically review and perform a meta-analysis on the existing literature regarding the use of ablative therapies in iCCA; and to assess their efficacy as a treatment modality by calculating pooled survival results and investigate associations between prognostic factors and survival. Methods: A comprehensive search of the PubMed database for relevant articles was performed. Studies assessing survival in patients with iCCA undergoing ablation were included. Data were extracted on patient, tumour and treatment characteristics and survival. Random effects meta-analysis was used to pool the data. Galbraith plots were used to investigate heterogeneity; bubble plots were formulated using regression-based meta-analysis. Results: 10 studies were included in the final analysis, yielding an aggregate of 206 patients (69.5% male, median age 51.2-72.5) and 320 tumours. 70.4% of patients were recurrent cases of iCCA and 29.6% primary iCCA. Median overall survival ranged from 8.7 to 52.4 months. Pooled survival rates for 1, 3 and 5-year survival were 76% (95% CI: 68-83%), 33% (21-44%) and 16% (7-26%), respectively. No significant association was found between the median age, number of tumours or median tumour size and 1-year survival. Conclusion: Ablative therapies display promising potential as treatment modalities for iCCA. However, further research is necessary to validate these findings.
Issue Date: Nov-2019
Date of Acceptance: 2-Aug-2019
URI: http://hdl.handle.net/10044/1/72810
DOI: 10.1016/j.jceh.2019.08.001
ISSN: 0973-6883
Publisher: Elsevier
Start Page: 740
End Page: 748
Journal / Book Title: Journal of Clinical and Experimental Hepatology
Volume: 9
Issue: 6
Copyright Statement: © 2019 Indian National Association for Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Sponsor/Funder: Wellcome Trust
Wellcome Trust
Wellcome Trust
Funder's Grant Number: 097816/Z/11/ZR
097816/Z/11/A
097816/Z/11/B
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
intrahepatic
cholangiocarcinoma
ablation
RADIOFREQUENCY ABLATION
THERMAL ABLATION
EPIDEMIOLOGY
GEMCITABINE
EXPERIENCE
MANAGEMENT
CISPLATIN
DIAGNOSIS
MORTALITY
SURVIVAL
CCA, cholangiocarcinoma
DFS, disease-free survival
EFS, event-free survival
HBV, hepatitis B virus
HCV, hepatitis C virus
LT, liver transplantation
MWA, microwave ablation
OS, overall survival
PFS, progression-free survival
RFA, radiofrequency ablation
RFS, recurrence-free survival
ablation
cholangiocarcinoma
eCCA, extrahepatic cholangiocarcinoma
iCCA, intrahepatic cholangiocarcinoma
intrahepatic
pCCA, perihilar cholangiocarcinoma
Publication Status: Published
Online Publication Date: 2019-08-19
Appears in Collections:School of Public Health