Journal of Gastrointestinal Surgery

, Volume 13, Issue 3, pp 486–491

Radiofrequency Ablation vs. Resection for Hepatic Colorectal Metastasis: Therapeutically Equivalent?

Authors

  • Nathaniel P. Reuter
    • Division of Surgical Oncology, Department of SurgeryUniversity of Louisville School of Medicine
  • Charles E. Woodall
    • Division of Surgical Oncology, Department of SurgeryUniversity of Louisville School of Medicine
  • Charles R. Scoggins
    • Division of Surgical Oncology, Department of SurgeryUniversity of Louisville School of Medicine
  • Kelly M. McMasters
    • Division of Surgical Oncology, Department of SurgeryUniversity of Louisville School of Medicine
    • Division of Surgical Oncology, Department of SurgeryUniversity of Louisville School of Medicine
original article

DOI: 10.1007/s11605-008-0727-0

Cite this article as:
Reuter, N.P., Woodall, C.E., Scoggins, C.R. et al. J Gastrointest Surg (2009) 13: 486. doi:10.1007/s11605-008-0727-0

Abstract

Introduction

The role of ablation for hepatic colorectal metastases (HCM) continues to evolve as ablation technology changes and systemic chemotherapy improves. Our aim was to evaluate the therapeutic efficacy of radiofrequency ablation (RFA) of HCM compared to surgical resection.

Methods

A retrospective review of our 1,105 patient prospective hepatic database from August 1995 to July 2007 identified 192 patients with only hepatic resection or only ablation for HCM.

Results

Patients who underwent RFA were similar to resection patients based on a similar Fong score (1.8 vs. 2.1 p = 0.28), presence of extrahepatic disease (15% vs. 9% p = 0.19), mean number of hepatic lesions (2.8 vs. 2.1 p = 0.14), and prior chemotherapy (67% vs. 60% p = 0.33). Median time to recurrence was shorter with ablation than resection (12.2 vs. 31.1 months; p < 0.001). Recurrence at the ablation–resection site was more common with ablation than resection occurring 17% vs. 2% (p ≤ 0.001) of the time, respectively. Distant recurrence in the liver was also more common with ablation occurring in 33% of patients vs. 14% for resection (p = 0.002).

Conclusions

Surgical resection is associated with a lower chance of recurrence and a longer disease-free interval than RFA and should remain the treatment of choice in resectable HCM.

Keywords

Radio frequency ablationHepatic resectionColorectal liver metastasis

Copyright information

© The Society for Surgery of the Alimentary Tract 2008