[Radiofrequency ablation of colorectal liver metastases]

Radiofrequency (RF) ablation is a method that uses electrical current for thermal destruction of solid tumours. We present our experience with RF ablation in a patient population with non-resectable colorectal liver metastases.

17 of the 23 patients with non-resectable liver metastases treated with RF ablation at Rikshospitalet University Hospital from 2003 to 2006, were included in a prospective non-randomized study with standardized follow-up.

RF ablation was used to treat one liver metastasis in each patient, and was combined with liver resection in seven patients. The median follow-up time after RF ablation was 29 months (14-55). One-year survival was 100% and survival after both two and three years was 67%. Follow-up examinations revealed local tumour progression at the RF-treated site in eight patients, intrahepatic recurrences not related to the RF-treated site in eight patients and extrahepatic recurrence in nine patients. Four patients with intrahepatic recurrence were re-treated with a curative intent.

Long-term survival is possible after RF ablation of selected patients with non-resectable colorectal liver metastases. Local tumour progression, intrahepatic- and extrahepatic tumour recurrence is common after RF ablation. Systematic follow-up can identify tumour recurrences that may be re-treated with a curative intent. Liver resection should still be considered the gold standard for patients with resectable colorectal liver metastases.