Percutaneous endobiliary radiofrequency ablation and stent placement for unresectable malignant biliary obstruction: a propensity score matching retrospective study.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY BMC Gastroenterology Pub Date : 2024-08-19 DOI:10.1186/s12876-024-03357-x

Wei Cui, Jing-Zhi Huang, Qi Wang, Feng Shi, Qing Gou, Xiao-Ming Chen, Jing Zhang, Jia-Ping Li, Rongde Xu

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Abstract

Background: Whether endobiliary radiofrequency ablation (EB-RFA) changes the standard role of stent placement in treating unresectable malignant biliary obstruction (MBO) remains unclear. The aim of this study is to compare percutaneous EB-RFA and metal stent placement (RFA-Stent) with metal stent placement alone (Stent) in treating unresectable MBO using a propensity score matching (PSM) analysis.

Methods: From June 2013 to June 2018, clinical data from 163 patients with malignant biliary obstruction who underwent percutaneous RFA-Stent or stenting alone were retrospectively analyzed using a nearest-neighbor algorithm to one-to-one PSM analysis to compare primary and secondary stent patency (PSP, SSP), overall survival (OS) and complications between the two groups.

Results: Before matching, for whole patients, RFA-Stent resulted in longer median PSP (8.0 vs. 5.1 months, P = 0.003), SSP (9.8 vs. 5.1 months, P < 0.001) and OS (7.0 vs. 4.5 months, P = 0.034) than the Stent group. After matching (54 pairs), RFA-Stent also resulted in better median PSP (8.5 vs. 5.1 months, P < 0.001), SSP (11.0 vs. 6.0 months, P < 0.001), and OS (8.0 vs. 4.0 months, P = 0.007) than Stent. RFA-Stent was comparable with Stent for complication rates. In Cox analysis, RFA-Stent modality and serum total bilirubin level were independent prognostic factors for PSP. RFA-Stent modality, performance status score and combination therapy after stent were independent prognostic factors for OS.

Conclusion: Percutaneous RFA-Stent was superior to Stent in terms of PSP, SSP, and OS in selected patients with unresectable MBO.

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经皮胆道内射频消融术和支架置入术治疗不可切除的恶性胆道梗阻：倾向评分匹配回顾性研究。

背景：胆道内射频消融（EB-RFA）是否会改变支架置入在治疗不可切除的恶性胆道梗阻（MBO）中的标准作用，目前仍不清楚。本研究旨在通过倾向评分匹配（PSM）分析，比较经皮 EB-RFA 和金属支架置入术（RFA-Stent）与单纯金属支架置入术（Stent）在治疗不可切除的 MBO 中的作用：2013年6月至2018年6月，对163例接受经皮RFA-Stent或单纯支架置入术的恶性胆道梗阻患者的临床数据进行回顾性分析，采用最近邻算法进行一对一PSM分析，比较两组患者的主要和次要支架通畅率（PSP、SSP）、总生存率（OS）和并发症：结果：在匹配前，对于所有患者，RFA-支架的中位PSP（8.0个月 vs. 5.1个月，P = 0.003）和SSP（9.8个月 vs. 5.1个月，P对于选定的不可切除 MBO 患者，经皮 RFA 支架在 PSP、SSP 和 OS 方面优于支架。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Gastroenterology 医学-胃肠肝病学

CiteScore

4.20

自引率

0.00%

发文量

465

审稿时长

6 months

期刊介绍： BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.