title: Hepatectomy plus intraoperative radiofrequency ablation and chemotherapy to treat technically unresectable multiple colorectal liver metastases.
abstract: BACKGROUND
  Results and indications of intra-operative radiofrequency (RF) ablation of liver metastases (LM) are not well defined in the literature.
  
  
  OBJECTIVE
  To appreciate the survival rate of patients with strictly unresectable LM (defined on technical but not oncological criteria) when undergoing liver resection plus RF, along with optimal systemic chemotherapy.
  
  
  METHODS
  Sixty three patients with technically unresectable LM (either >5, or bilateral with no sparing of at least one sector of the liver, or with tumor proximity to central major vascular structures) were treated. Extrahepatic metastases were also resected in 27% of patients. All patients received perioperative chemotherapy. The median follow-up was 27.6 months (range: 15-74).
  
  
  RESULTS
  There was no postoperative mortality and the morbidity rate was 27%. The 2-year overall survival rate of the 63 patients was 67% with a median survival of 36 months. The local recurrence rates were similar for the three types of local treatments: 7.1% for the 154 RF ablations, 7.2% for the 55 wedge resections, and 9% for the 44 segmental anatomic resections (P = 0.216). Hepatic recurrences occurred in 71% of patients.
  
  
  CONCLUSIONS
  The combination of anatomic segmental and wedge resections, RF ablation, and optimal chemotherapy in patients with technically unresectable LM results in a median survival of 36 months.
authors.affiliation: Department of Surgical Oncology, Gustave Roussy Institute, Villejuif, France. elias@igr.fr
authors.forename: Dominique
authors.initials: D
authors.lastname: Elias
authors.forename: Olivier
authors.initials: O
authors.lastname: Baton
authors.forename: Lucas
authors.initials: L
authors.lastname: Sideris
authors.forename: Valérie
authors.initials: V
authors.lastname: Boige
authors.forename: David
authors.initials: D
authors.lastname: Malka
authors.forename: Gabriel
authors.initials: G
authors.lastname: Liberale
authors.forename: Marc
authors.initials: M
authors.lastname: Pocard
authors.forename: Philippe
authors.initials: P
authors.lastname: Lasser
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016019:Survival Analysis