Percutaneous radiofrequency ablation in intrahepatic cholangiocarcinoma: a retrospective single-center experience

Figures & data

Table 1. Baseline characteristics 29 patients who underwent RFA from January 2014 to June 2019.

Patients	(n = 29)
Sex
Male	9 (31%)
Female	20 (69%)
Median age
	63 years, range 35–84
Size of lesions (mm)
	Median 17, range 5–48
Number of ablations per patient
	Median 3, range 2–7
Duration of follow-up (months)
	Median 39.9, range 2–55
MELD score
	Median 7, range 6–22
Bilirubin levels (mg/dL) before RFA
	Median 0.53, range 0.66–2.2
GGT levels (mg/dL) before RFA
	Median 32, range 23–115

GGT: gamma-glutamyl transpeptidase; RFA: radiofrequency ablation.

Figure 1. Receiver operating characteristic (ROC) curve on the 6 months Local Tumor Progression-Free Survival (LTPFS). Area under the curve (AUC) was 0.712 (95% CI 0.61–0.82) for the largest diameter of the nodule (p.001). Based on ROC curve we choose 20 mm as the best cutoff (sensitivity 69%, specificity 70%).

Figure 2. Local Tumor Progression-Free Survival (LTPFS) of tumors < 20 mm and ≥ 20 mm in diameter. Median LTPFS was 6.6 months (range 5.1–8.2) for lesions ≥ 20 mm and 12.9 months (range 11.5–14.2) in tumors < 20 mm.

Table 2. Univariate and multivariate analysis for factors affecting LTPFS.

	Univariate		Multivariate		Internal validation
Variable	HR (95% CI)	p Value	HR (95% CI)	p Value	BCa 95% CI
ECOG PS
0	1 [Reference]	0.77		0.51
1	1.07 (0.66–1.75)
Number of lesions	0.97 (0.89–1.06)	0.48
MELD score
<9	1 [Reference]	0.22		0.57
≥9	0.67 (0.35–1.28)
Lesion size
<20 mm	1 [Reference]	0.001		0.001
≥20 mm	3.68 (2.37–5.73)		3.68 (2.37–5.73)		4.04 (2.47–5.93)
Total bilirubin (mg/dL)
<1.2	1 [Reference]	0.48
≥1.3	1.31 (0.63–2.71)
GGT levels
<ULN	1 [Reference]	0.9
≥ULN	1.03 (0.67–1.57)
Platelet count
<ULN and > LLN	1 [Reference]	0.4
≥ULN	1.86 (0.44–7.81)
Platelet count
<ULN and  ≥ LLN	1 [Reference]	0.56
<LLN	0.88 (0.56–1.37)

Univariate and multivariate analysis showed that tumor size less than 20 mm was an independent prognostic factor of LTPFS. Significant factors are depicted in bold. LTPFS: Local Tumor Progression-Free Survival; HR: Hazard Ratio; CI: confidence interval; BCA: bias-corrected and accelerated (BCa) bootstrap; ECOG-PS: Eastern Cooperative Oncology Group Performance Status; MELD: Model for End-Stage Liver Disease; GGT: Gamma-Glutamyl Transpeptidase; ULN: upper limit of normal; LLN: lower limit of normal.

Figure 3. Overall Survival (OS) from the date of Radiofrequency Ablation (RFA) for all patients included.

Table 3. Results of univariate and multivariate analysis for factors affecting OS.

	Univariate		Multivariate
Variable	HR (95% CI)	p Value	HR (95% CI)	p Value
ECOG-PS
0	1 [Reference]	0.57
1	1.39 (0.44–4.32)
Number of overall sessions of RFA	0.89 (0.75–1.06)	0.19
MELD score
<9	1 [Reference]	0.18
≥9	1.52 (0.40–5.78)
Number of overall nodules treated with RFA	1.58 (0.93–2.67)	0.9	1.87 (1.07–3.27)	0.028
Sum of diameter of nodules at the moment of first RFA (mm)	4.67 (0.68–32.06)	0.9	9.55 (1.1–82.6)	0.04
Diameter of the biggest nodule at the moment of first RFA (mm)	1.04 (0.98–1.19)	0.21

Number of lesions and the sum of their diameters at the moment of the first RFA significantly affected overall survival in multivariate analysis. Significant factors are depicted in bold. OS: Overall Survival; HR: Hazard Ratio; CI: confidence interval; ECOG-PS: Eastern Cooperative Oncology Group Performance Status; RFA: radiofrequency ablation; MELD: Model for End-Stage Liver Disease.