Comparison of hepatic recurrences after resection or intraoperative radiofrequency ablation indicated by size and topographical characteristics of the metastases.
OBJECTIVE
Intraoperative use of radiofrequency ablation (IRFA) to treat liver metastases is controversial. The aim of this study was to compare local recurrence rate and survival after IRFA versus resection.


METHODS
Three groups from 99 patients were consecutively operated on for 307 liver metastases with 2years of follow up: group 1, IRFA alone (n=34); group 2, IRFA plus resection (n=28); group 3, resection alone (n=37). The choice of IRFA or resection was made on the basis of the sizes and topographies of the metastases with the goal of achieving R0 treatment.


RESULTS
Mortality was zero; morbidity was 9%, 11% and 11% in the three groups respectively. Median follow-up after surgery was 30months. Total hepatic recurrences occurred in 59 (60%) patients. Median survival without hepatic recurrence was 17months with no difference between the three groups (P=0.474). Total local recurrence occurred in 4 (12%) patients in group 1, in 2 (8%) patients in group 2, and in 2 (6%) patients in group 3. Survival at 2years was no different in the three groups.


CONCLUSIONS
Assessing IRFA indications by size and the topographical characteristics of the liver metastases yields identical local recurrence rates to resection after 2years of follow up.
Leblanc
F
F
Digestive Tumours Unit, Institut Bergonie, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33076 Bordeaux, France.
Fonck
M
M
Brunet
R
R
Becouarn
Y
Y
Mathoulin-Pélissier
S
S
Evrard
S
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D007430:Intraoperative Care / Q000379:methods; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011336:Probability; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D047368:Tumor Burden