Photodynamic Therapy (PDT), Radiofrequency Ablation (RFA) With Biliary Stents in Palliative Treatment of Unresectable Extrahepatic Cholangiocarcinoma: A Systematic Review and Meta-analysis.
J Clin Gastroenterol
; 56(2): e153-e160, 2022 02 01.
Article
en En
| MEDLINE
| ID: mdl-33780214
ABSTRACT
BACKGROUND AND AIM:
Extrahepatic unresectable cholangiocarcinoma carries a dismal prognosis. In addition to biliary drainage by stent placement; photodynamic therapy (PDT) and radiofrequency ablation (RFA) have been tried to prolong survival. In this meta-analysis, we appraise the current known data on the use of PDT, RFA in the palliative treatment of extrahepatic unresectable cholangiocarcinoma.METHODS:
We searched multiple databases from inception through July 2020 to identify studies that reported on PDT and RFA. Pooled rates of survival, stent patency, 30-, 90-day mortality, and adverse events were calculated. Study heterogeneity was assessed using I2% and 95% prediction interval.RESULTS:
A total of 55 studies (2146 patients) were included. A total of 1149 patients underwent treatment with PDT (33 studies), 545 with RFA (22 studies), and 452 patients with stent-only strategy. The pooled survival rate with PDT, RFA, and stent-only groups was 11.9 [95% confidence interval (CI) 10.7-13.1] months, 8.1 (95% CI 6.4-9.9) months, and 6.7 (95% CI 4.9-8.4) months, respectively. The pooled time of stent patency with PDT, RFA, and stent-only groups was 6.1 (95% CI 4.2-8) months, 5.5 (95% CI 4.2-6.7) months, and 4.7 (95% CI 2.6-6.7) months, respectively. The pooled rate of 30-day mortality with PDT was 3.3% (95% CI 1.6%-6.7%), with RFA was 7% (95% CI 4.1%-11.7%) and with stent-only was 4.9% (95% CI 1.7%-13.1%). The pooled rate of 90-day mortality with PDT was 10.4% (95% CI 5.4%-19.2%) and with RFA was 16.3% (95% CI 8.7%-28.6%).CONCLUSION:
PDT seemed to demonstrate better overall survival and 30-day mortality rates than RFA and/or stent-only palliation.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fotoquimioterapia
/
Neoplasias de los Conductos Biliares
/
Ablación por Catéter
/
Colangiocarcinoma
/
Ablación por Radiofrecuencia
Tipo de estudio:
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Clin Gastroenterol
Año:
2022
Tipo del documento:
Article