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SIR 2026

Scientific Session

Interventional Oncology

Session: IO - Liver Ablation

136 - Safety and Survival Outcomes of Ablation for the Treatment of Intrahepatic Cholangiocarcinoma: A Large Academic Center’s 20-Year Experience

Monday, April 13, 2026
4:03 PM - 4:12 PM ET
Purpose: Intrahepatic Cholangiocarcinoma (ICC) is the second most common primary liver cancer, second only to Hepatocellular Carcinoma. If left untreated, the median survival of ICC from time of diagnosis is grim—reported at just 6.5 months—making effective treatment imperative.{1} The current gold standard for treating early-stage ICC is surgical resection, with consideration for coupled adjuvant chemotherapy.{2} Current practice often limits Interventional Radiology (IR)-facilitated local treatment options, such as ablation, to surgically irresectable cases despite a few prior reports of similar overall survival in comparison to surgery.

Materials and Methods: In this study, we conducted a single center retrospective analysis from patient cases at a large United States based academic center. To our knowledge, this is the largest reported US-based single-center study analyzing multiple ablation modalities for the treatment of ICC. We included patients who underwent treatment for radiology or pathology confirmed pure ICC with either microwave ablation, cryoablation, radiofrequency ablation, or pulsed field ablation.

Results: We analyzed a total of 64 patients with 103 pure ICC ablations between 2005 and 2025. In aggregate, the 1-year, 3-year, and 5-year overall survival (OS) was 78.4% (95% CIs, 70.5%-87.3%), 51.2% (95% CIs, 41.3%-63.4%), and 43.9% (95% CIs, 33.7%-57.2%), respectively.

Conclusion: Multiple prior studies on curative-intent surgical hepatectomies for ICC treatment report 5-year OS at around 30%.{3} Thus, the 20-year experience of our hospital center suggests that ablation produces similar, if not improved 5-year OS outcomes compared to current surgical outcome reports. Furthermore, preliminary analysis of our data supports prior studies that suggest that ablations have a more favorable complication profile compared to surgery.{3,4} On an individual level, several patients were longitudinally managed by IR with repeat ablations who well-surpassed the 5-year survival mark. Characterizing these cases may support the expansion of IR’s role into a clear clinical guideline pathway for pursuing IR-administered treatment as the longitudinal treatment option or first-line treatment option for a category of ICC cases.