Local recurrences after intraoperative radiofrequency ablation of liver metastases: a comparative study with anatomic and wedge resections.
BACKGROUND
The indications and results of intraoperative radiofrequency ablation (RFA) of liver metastases (LMs) are not well defined in the literature and have never been compared with those of hepatectomy. The aim of the study was to appreciate the local recurrence rate of RFA in comparison with anatomic and wedge resection.


METHODS
Eighty-eight patients with technically unresectable LMs were treated with curative intent. The LMs were treated by anatomic resection (40 patients, 213 LMs) when large, by wedge resection (64 patients, 99 LMs) when peripheral and small, and by RFA (88 patients, 227 LMs) when central and small. The median follow-up was 27.6 months (range, 15-74 months), and a total of 539 LMs were treated (median of 5 per patient).


RESULTS
The local recurrence rates were 5.7% for the 227 RFAs, 7.1% for the 99 wedge resections, and 12.5% for the 40 anatomic resections (P =.216). Local recurrence rates after RFA were correlated with LMs larger than 30 mm (P <.001) and with LMs in direct contact with large vessels (P <.001).


CONCLUSIONS
RFA is as efficient and safe as wedge or anatomic resections in terms of local control.
Elias
Dominique
D
Division of Surgical Oncology, Department of Surgery, Gustave Roussy Institute, 39 Rue Camille Desmoulins, 94805 Villejuif Cedex, France. elias@igr.fr.
Baton
Olivier
O
Sideris
Lucas
L
Matsuhisa
Tadashi
T
Pocard
Marc
M
Lasser
Philippe
P
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome