Effect of endoscopic radiofrequency ablation on the survival of patients with inoperable malignant biliary strictures: A large cohort study.

Background and Aims: Endoscopic radiofrequency ablation (RFA) is an emerging technique for the palliation of inoperable malignant biliary strictures (MBSs). We aimed to systemically investigate the long‐term outcome of RFA in a large cohort of patients. Methods: We recruited 883 patients with various MBSs who underwent endoscopic interventions at two large‐volume centers; 124 patients underwent RFA and stenting, whereas 759 underwent stenting alone. To overcome selection bias, we performed 1:4 propensity score matching (PSM). The main outcome was overall survival (OS). Results: Following PSM, patients in the RFA group showed significantly longer OS (9.5 months; 95% CI: 7.7‐11.3 months) than those in the stenting alone group (6.1 months; 95% CI: 5.6‐6.6 months; P <.001). In stratified analyses, the improved OS was only demonstrated in the subgroup of extrahepatic cholangiocarcinoma (11.3 months 95% CI: 10.2‐12.4 vs 6.9 months 95% CI: 6.0‐7.8; P <.001), but not in the subgroups of gallbladder cancer, hepatocellular carcinoma, intrahepatic cholangiocarcinoma, pancreatic cancer, and other metastatic cancers (all P >.05). The survival benefits were noted only in the patients with non‐metastatic cholangiocarcinoma (11.5 vs 7.4 months, P <.001). Conclusions: The survival benefits of endoscopic RFA appear to be limited to patients with extrahepatic cholangiocarcinoma without distant metastasis. [ABSTRACT FROM AUTHOR]