Patterns of recurrence following selective intraoperative radiofrequency ablation as an adjunct to hepatic resection for colorectal liver metastases

Abstract

RFA was used as an adjunct to resection in patients with greater disease burden. Despite this, RFA was not significantly associated with a higher risk of local failure and was not associated with worse survival, when compared with liver resection alone.

Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis

“…4). Fourteen studies compared RFA with surgery alone [13, 30–42], eight studies compared RFA + PH with PH alone [13, 15, 16, 18, 27, 28, 43, 44], and four studies compared RFA to RFA + PH or PH alone [13, 45–47]. A total number of 5020 patients were included in these observational studies (RFA: N  = 1103; RFA + PH: N  = 541; PH alone: N  = 3376).…”

“…Five-year survival following ablation varies between 17 and 53% [9–13]. Although recent studies [13–16] have reported similar survival for patients treated with thermal ablation or PH, interventional radiology and surgical oncology communities generally state that thermal ablation cannot be considered an alternative to PH. They recommend the use of open, laparoscopic or percutaneous RFA and MWA for small CRLM (≤ 3 cm) in patients who are unsuitable for resection due to (1) an impaired general health status (age, comorbidities), (2) a history of extensive abdominal surgery, (3) the presence of lesions with an unfavourable location or (4) an insufficient future liver remnant to resect all lesions [11, 17, 18].…”

Radiofrequency Ablation for Neuroendocrine Liver Metastases: A Systematic Review

“…Interventional radiologic options in liver tumors include embolization and ablative techniques (19)(20)(21)(22)(23)(24). Data from studies on RF ablation in primary hepatocellular carcinoma suggest that RF ablation is effective in this disease and has several advantages, as it can be used repeatedly and has a low sideeffect profile (7,8,25). NETs have distinct and varied tumor biology, which provides a rationale to study them as a group separate from other tumors (26).…”

64. Combined Ablation and Resection (CARe) as an effective parenchymal sparing treatment for extensive colorectal liver metastases

“…Technical implementations require a high-level of expertise in IOUS for the liver surgeon. Along with increasing reports of an extension of the indications for RFA [7,28], this report marks the end of a taboo indicating that RFA is now approved to complement resection or, in selected cases, to replace it.…”