SynthesisLiver international : official journal of the International Association for the Study of the Liver2026
Radiological Loco-Regional Treatments for Cholangiocarcinoma: A Systematic Review of the Literature.
Synthesis in Liver international : official journal of the International Association for the Study of the Liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Radiological Loco-Regional Treatments for Cholangiocarcinoma: A Systematic Review of the Literature.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cholangiocarcinoma (CCA) is the second most common primary liver cancer and is being diagnosed with increasing frequency worldwide. We performed a systematic review on radiofrequency (RFA), microwave (MWA), irreversible electroporation (IRE), trans-arterial chemoembolization (TACE) and selective internal radiation therapy (SIRT) in CCA. Thirty-one ablation studies (1526 patients), 21 TACE studies (1594 patients), and 38 SIRT studies (1954 patients) were included; most cohorts involved intrahepatic CCA (iCCA) and originated from Asia. For RFA/MWA, overall survival (OS) typically exceeded 25 months and recurrence-free survival (RFS) 7-9 months. The ideal candidate profile for percutaneous ablation was an uninodular iCCA measuring ≤ 2-3 cm developed on cirrhosis. For TACE, median objective response rate (ORR) was 35%, with median OS 11.7 months and RFS of 4 months. Hypervascularity, low tumour burden (< 30%-50% of liver involvement), and preserved liver function were associated with better outcomes and may be used to identify suitable candidates for TACE in case of unresectable iCCA. For SIRT, median ORR was 36.3%, OS 14.5 months, and RFS 8.7 months. A large unilobar tumour with personalised dosimetry appears the best candidate for SIRT in unresectable iCCA, with potential for downstaging to surgery in some cases. However, the literature regarding locoregional treatment is predominantly retrospective and heterogeneous, with inconsistent reporting of staging, cirrhosis, and endpoints, and almost no randomised trials. Locoregional radiological therapies remain viable options for carefully selected, liver-dominant iCCA, but prospective multicenter studies are needed to define indications, and to optimise sequencing and combination strategy with systemic treatments.
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