title: Intraoperative thermal ablation therapy for small colorectal metastases to the liver.
abstract: OBJECTIVE
  Thermal ablation (TA) therapies such as microwave coagulation therapy (MCT) and radiofrequency interstitial thermal ablation (RFA) for colorectal metastasis to the liver cannot always achieve a complete tumor cell death, and the multiple insertions of the TA probe may lead to intrahepatic dissemination and/or distant metastasis.
  
  
  METHODS
  The achieved local control rate, any recurrence in the residual liver, and any extrahepatic recurrence has been evaluated in 105 patients who underwent hepatectomy and/or intraoperative TA between 1994 and 2004.
  
  
  RESULTS
  A total of 102 unresectable liver metastatic lesions (mean size 21mm) were selectively treated with TA either as initial treatment (32 patients) and/or as re-treatment (18 patients) for recurrence in the residual liver, in combination with hepatectomy. Overall, TA achieved a high local tumor control rate of 95%. Multivariate analysis revealed that initial-TA therapy was not a significant predictive factor of hepatic recurrence or any recurrence.
  
  
  CONCLUSIONS
  TA therapies in combination with hepatectomy may offer increased resectability without increased risk of intrahepatic dissemination or extrahepatic recurrence for certain patients who would otherwise be deemed inoperable, when relatively small tumors are indicated for TA.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan. yogata@med.kurume-u.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ogata
authors.forename: Shinji
authors.initials: S
authors.lastname: Uchida
authors.forename: Toru
authors.initials: T
authors.lastname: Hisaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horiuchi
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Mori
authors.forename: Nobuya
authors.initials: N
authors.lastname: Ishibashi
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Akagi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D015996:Survival Rate