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  • Time to focus on the real potential benefit of endobiliary radiofrequency ablation: stent patency in patients with cholangiocarcinoma

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Letter
Time to focus on the real potential benefit of endobiliary radiofrequency ablation: stent patency in patients with cholangiocarcinoma
  1. Jeska A Fritzsche1,2,3,
  2. Esmée Smit1,3,
  3. Cyriel Y Ponsioen1,2,3,
  4. Rogier P Voermans1,2,3
  1. 1 Department of Gastroenterology and Hepatology, University of Amsterdam, Amsterdam, The Netherlands
  2. 2 Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
  3. 3 Cancer Centre Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Jeska A Fritzsche, Department of Gastroenterology and Hepatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, 1081 HV, The Netherlands; j.a.fritzsche{at}amsterdamumc.nl; Rogier P Voermans; r.p.voermans{at}amsterdamumc.nl

https://doi.org/10.1136/gutjnl-2023-331359

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    We were delighted to read the article by Jarosova et al, which presents the results of a randomised controlled trial investigating the efficacy of endobiliary radiofrequency ablation (eRFA).1 The authors should be commended for conducting this large trial not only in pancreatic cancer but also, much rarer, perihilar cholangiocarcinoma (pCCA) patients.

    Endobiliary RFA uses high frequency current to generate heat, which results in coagulation and local tumour necrosis, possibly leading to delayed tumour growth. Theoretically, the potential benefit of eRFA is larger in tumours that originate from the bile duct itself rather than compressing the bile duct, such as pancreatic cancer. The safety and feasibility have been shown in multiple studies, but the efficacy has not been sufficiently studied in randomised trials yet.2–4 Unfortunately, current trial has not been able to show the superiority …

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    Footnotes

    • Contributors JAF drafted the letter, all other authors critically reviewed the letter.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JAF and ES have no conflicts of interest or financial ties to disclose. RPV reports research grants from Boston Scientific and Prion Medical, performed as a consultant for Boston Scientific and Cook Medical, and received speaker’s fee from Mylan and Zambon. CYP reports research grants from Gilead, Perspectum, advisory work for Pliant, Chemomab, NGM, and Takeda, and speaker’s fee from Tillotts. All outside the submitted work.

    • Provenance and peer review Not commissioned; internally peer reviewed.