Intraductal radiofrequency ablation plus biliary stent versus stent alone for malignant biliary obstruction: a systematic review and meta-analysis

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorVERAS, Matheus de Oliveira
dc.contributor.authorMOURA, Diogo Turiani Hourneaux de
dc.contributor.authorMCCARTY, Thomas R.
dc.contributor.authorOLIVEIRA, Guilherme Henrique Peixoto de
dc.contributor.authorGOMES, Romulo Sergio Araujo
dc.contributor.authorLANDIM, Davi Lucena
dc.contributor.authorNUNES, Felipe Giacobo
dc.contributor.authorFRANZINI, Tomazo Antonio Prince
dc.contributor.authorSANTOS, Marcos Eduardo Lera dos
dc.contributor.authorBERNARDO, Wanderley Marques
dc.contributor.authorMOURA, Eduardo Guimaraes Hourneaux de
dc.date.accessioned2024-02-15T14:55:31Z
dc.date.available2024-02-15T14:55:31Z
dc.date.issued2024
dc.description.abstractBackground and study aims Recurrent biliary stent occlusion and tumor ingrowth remain a major concern among patients with malignant biliary obstruction (MBO) with significant impact on patient morbidity and survival. Intraductal radiofrequency ablation (RFA) has emerged as a promising treatment that seeks to extend stent patency. This study aimed to evaluate the impact of RFA on overall survival (OS) and stent patency among patients with unresectable MBO.Methods A comprehensive search of electronic databases was performed for randomized controlled trials (RCTs) comparing RFA plus biliary stent (RFA+S) versus biliary stent alone (S-alone). Outcomes assessed included overall survival, stent patency, and adverse events (AEs) with mean difference (MD) calculated from pooled proportions. Subgroup analyses were performed for hilar strictures and cholangiocarcinoma (CCA).Results Six RCTs (n=439 patients) were included and demonstrated improved survival among patients who received RFA+S (MD 85.80 days; 95% confidence interval [CI] 35.02-136.58; I 2 =97%; P <0.0009). The pooled MD for total stent patency was 22.25 days (95% CI 17.38-61.87; I (2) =97%; P =0.27). There was no difference in AEs between RFA+S vs S-alone ( P >0.05). On subgroup analyses, RFA+S was associated with improved stent patency (MD 76.73 days; 95% CI 50.11-103.34; I 2 =67%; P <0.01) and OS (MD 83.14 (95% CI 29.52-136.77; I- 2 =97%; P <0.01] for CCA. For hilar strictures, stent patency was improved among patients with RFA+S [MD 83.71 days (95% CI 24.85-142.56; I 2 =84%; P <0.01].Conclusions RFA+S improved OS in the treatment of MBO when compared with S-alone. Moreover, the RFA therapy prolonged stent patency in hilar strictures and CCA, with similar rates of AEs.eng
dc.description.indexPubMed
dc.description.indexWoS
dc.identifier.citationENDOSCOPY INTERNATIONAL OPEN, v.12, n.1, p.E23-E33, 2024
dc.identifier.doi10.1055/a-2204-8316
dc.identifier.eissn2196-9736
dc.identifier.issn2364-3722
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58171
dc.language.isoeng
dc.publisherGEORG THIEME VERLAG KGeng
dc.relation.ispartofEndoscopy International Open
dc.rightsopenAccesseng
dc.rights.holderCopyright GEORG THIEME VERLAG KGeng
dc.subjectStrictureseng
dc.subjectPTCD/PTCSeng
dc.subject.otherstrictureseng
dc.subject.othermanagementeng
dc.subject.othersurvivaleng
dc.subject.wosGastroenterology & Hepatologyeng
dc.subject.wosSurgeryeng
dc.titleIntraductal radiofrequency ablation plus biliary stent versus stent alone for malignant biliary obstruction: a systematic review and meta-analysiseng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalMCCARTY, Thomas R.:Yale Univ, Sch Med, Internal Med, New Haven, CT USA
hcfmusp.contributor.author-fmusphcMATHEUS DE OLIVEIRA VERAS
hcfmusp.contributor.author-fmusphcDIOGO TURIANI HOURNEAUX DE MOURA
hcfmusp.contributor.author-fmusphcGUILHERME HENRIQUE PEIXOTO DE OLIVEIRA
hcfmusp.contributor.author-fmusphcROMULO SERGIO ARAUJO GOMES
hcfmusp.contributor.author-fmusphcDAVI LUCENA LANDIM
hcfmusp.contributor.author-fmusphcFELIPE GIACOBO NUNES
hcfmusp.contributor.author-fmusphcTOMAZO ANTONIO PRINCE FRANZINI
hcfmusp.contributor.author-fmusphcMARCOS EDUARDO LERA DOS SANTOS
hcfmusp.contributor.author-fmusphcWANDERLEY MARQUES BERNARDO
hcfmusp.contributor.author-fmusphcEDUARDO GUIMARAES HOURNEAUX DE MOURA
hcfmusp.description.beginpageE23
hcfmusp.description.endpageE33
hcfmusp.description.issue1
hcfmusp.description.volume12
hcfmusp.origemWOS
hcfmusp.origem.pubmed38188927
hcfmusp.origem.wosWOS:001137079000004
hcfmusp.publisher.citySTUTTGARTeng
hcfmusp.publisher.countryGERMANYeng
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Artigos e Materiais de Revistas Científicas - HC/ICHC
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