Clinical outcomes of hepatic resection and radiofrequency ablation in patients with solitary colorectal liver metastasis

J Clin Gastroenterol. 2008 Sep;42(8):945-9. doi: 10.1097/MCG.0b013e318064e752.

Abstract

Background: The role of the radiofrequency ablation (RFA) in treatment of solitary liver metastasis has not been established yet. Both hepatic resection (HR) and RFA have been used increasingly in the treatment of colorectal liver metastases.

Study: A systemic review was performed to determine the impact of treatment modality of solitary liver metastasis on recurrence patterns, disease-free survival, and overall survival (OS) rates.

Results: Solitary liver metastases were treated by HR in 116 patients (75.8%) and 37 patients (24.2%) were treated with RFA. Prognostic factors, recurrence rate, recurrence patterns, and survival rates were analyzed. The cumulative 3-year and 5-year local recurrence free survival rates were markedly higher in the HR group (88.0% and 84.6%) as compared with those in the RFA group [53.3% and 42.6%, respectively (P</=0.001)]. The 5-year OS rate was lower in the RFA group as compared with the HR group without statistical significance (5-year OS, 65.7% in the HR, 48.5% in the RFA group, P=0.227).

Conclusions: Despite of higher local recurrence rate, RFA may be considered as a therapeutic option for patients who are considered unsuitable for conventional surgical treatment. Randomized prospective controlled trials comparing the therapeutic outcome of RFA and HR are definitely warranted.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation / methods*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hepatectomy / methods*
  • Humans
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome