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. 2011 Jul;81(1):25-34.
doi: 10.4174/jkss.2011.81.1.25. Epub 2011 Jul 11.

Comparative analysis of radiofrequency ablation and surgical resection for colorectal liver metastases

Kyung Ho Kim  1 , Yong Sik Yoon, Chang Sik Yu, Tae Won Kim, Hye Jin Kim, Pyo Nyun Kim, Hyun Kwon Ha, Jin Cheon Kim
Affiliations

Comparative analysis of radiofrequency ablation and surgical resection for colorectal liver metastases

Kyung Ho Kim et al. J Korean Surg Soc. 2011 Jul.

Abstract

Purpose: To evaluate the comparative therapeutic efficacy of radiofrequency ablation (RFA) and hepatic resection for the treatment of colorectal liver metastasis (CRLM).

Methods: Between 1996 and 2008, 177 patients underwent RFA, 278 underwent hepatic resection and 27 underwent combination therapy for CRLM. Comparative analysis of clinical outcomes was performed including number of liver metastases, tumor size, and time of CRLM.

Results: Based on multivariate analysis, overall survival (OS) correlated with the number of liver metastases and the use of combined chemotherapy (P < 0.001, respectively). Disease-free survival (DFS) also correlated with the number of liver metastases (P < 0.001). In the 226 patients with solitary CRLM < 3 cm, OS and DFS rates did not differ between the RFA group and the resection group (P = 0.962 and P = 0.980). In the 70 patients with solitary CRLM ≥ 3 cm, DFS was significantly lower in the RFA group as compared with the resection group (P = 0.015).

Conclusion: The results indicate that RFA may be a safe alternative treatment for solitary CRLM less than 3 cm, with outcomes equivalent to those achieved with hepatic resection. A randomized controlled study comparing RFA and resection for patients with single small metastasis would help to determine the most efficient treatment modalities for CRLM.

Keywords: Colorectal neoplasms; Hepatectomy; Liver metastasis; Radiofrequency ablation.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Examples of radiologic images indicating that radiofrequency ablation (RFA) was recommended in the current study. (A) Anatomic sites difficult for resection (left image, pre-RFA; right image, post-RFA). (B) Multiple lesions treated with combination therapy (left images, pre-treatment; right images, post-treatment).
Fig. 2
Fig. 2
Survival of patients with solitary colorectal liver metastasis less than 3 cm treated by radiofrequency ablation (RFA) and resection. (A) Overall survival (P = 0.962). (B) Disease-free survival (P = 0.980).
Fig. 3
Fig. 3
Survival of patients with solitary colorectal liver metastasis equal to or greater than 3 cm treated by radiofrequency ablation (RFA) and resection. (A) Overall survival (P = 0.152). (B) Disease-free survival (P = 0.015).
Fig. 4
Fig. 4
Survival of patients with multiple colorectal liver metastasis treated by radiofrequency ablation (RFA), resection and combination therapy. (A) Overall survival (P = 0.330). (B) Disease-free survival (P = 0.037).
See this image and copyright information in PMC

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