Combined resection and radiofrequency ablation for bilobar colorectal cancer liver metastases.

Background/aims: Traditionally multiple bilobar colorectal liver metastases were not considered suitable for surgical resection. The use of novel adjuncts to hepatic resection to aid tumour clearance is increasing. These include radiofrequency ablation (RFA), which destroys tumour tissue with high local temperatures. The present study reports a series of patients who underwent RFA and resection for bilobar colorectal liver metastases. Comparisons are made with patients undergoing hepatic resection alone over the same time period.

Methodology: 100 consecutive patients underwent curative hepatic resections for colorectal liver metastases (84--resection alone; 16--combined RFA and resection). Most were < 75 years (87%), male (57%), had metachronous disease (65%).

Results: Median follow-up was 37 months. 47/84 hepatic resection and 10/16 combined RFA and resection patients died from recurrent cancer. Median hospital stay, morbidity and mortality were similar in both groups. Actuarial 3-year cancer specific survival rates were 54% for resection alone and 38% for RFA plus resection although this difference was not significant.

Conclusion: A combined approach with RFA and resection achieves comparable perioperative outcomes in comparison to liver resection alone. With encouraging oncological outcomes, a combined approach is a potentially curative treatment option for patients with multiple bilobar hepatic metastases.