Endoscopic radiofrequency ablation for unresectable cholangiocarcinoma: a single-centre retrospective cohort study with patient interviews

BACKGROUND: This study assessed biliary drainage durability, survival, and patient experiences following endoscopic retrograde cholangiopancreatography (ERCP)-guided radiofrequency ablation (RFA) plus stenting for palliation in unresectable cholangiocarcinoma (CCA). METHODS: Ten patients with unresectable CCA were identified in a single-centre retrospective cohort study conducted in Norway between January 2019 and June 2025. Three surviving patients participated in semi-structured interviews. Primary outcomes were biliary drainage durability, survival, and patient experiences. Secondary outcomes included biliary drainage success, peri-procedural adverse events, biochemical response, and healthcare utilisation. RESULTS: The median time to unplanned biliary reintervention was 218 days, with 3- and 6-month estimates of 79.1% and 56.2%, respectively. The median survival from the first ERCP-RFA was 262 days, with 6- and 12-month estimates of 60.0% and 32.0%, respectively. Interviewed patients reported that feeling fit enough to continue chemotherapy and symptom relief were benefits of ERCP-RFA plus stenting. Post-procedure infection, which reduced time with family, was described as the main burden. CONCLUSION: ERCP-RFA plus stenting was feasible in this small cohort and was associated with short-term biliary decompression. Interviews indicated a perceived fitness for chemotherapy and meaningful symptom relief. However, frequent readmissions, mainly due to recurrent biliary obstruction, substantially increased the burden of hospital care during palliation. Future studies should evaluate ERCP-RFA plus stenting from a broader palliative perspective using patient-reported outcomes and hospitalisation burden as key endpoints.