title: Percutaneous stereotactic radiofrequency ablation of colorectal liver metastases.
abstract: OBJECTIVE
  To evaluate the outcome of patients with colorectal liver metastasis (CRLM) treated with stereotactic radiofrequency ablation (SRFA).
  
  
  METHODS
  Following IRB approval, a retrospective evaluation of 98 SRFA treatment sessions of 189 CRLMs in 63 consecutive patients was performed. Local recurrence rate (LR), overall survival (OS) and disease-free survival (DFS) were analysed.
  
  
  RESULTS
  LR was identified in 16% of the tumours (31/189), with no significant differences (P = 0.635) when comparing tumour sizes <3 cm (17.7%), 3-5 cm (11.1%) and >5 cm (17.4%). The median OS from SRFA treatment was 33.2 months after a mean follow-up of 25 months (range 2-66); the corresponding 1-, 3- and 5- year survival rates were 87%, 44% and 27%. The median OS was significantly different when comparing unresectable and resectable patients (27 vs. 58 months, P = 0.002) with OS rates of 92%, 66% and 48% at 1, 3 and 5 years in resectable patients. Tumour size did not affect OS and DFS.
  
  
  CONCLUSIONS
  Due to the favourable outcome, SRFA challenges resection as first-line local treatment of patients with CRLM. As long as randomised studies are pending, we recommend entering an individual decision-making process with every patient.
  
  
  CONCLUSIONS
  Large colorectal liver metastases can be effectively treated by stereotactic radiofrequency ablation (SRFA). Using SRFA the overall survival is not affected by tumour size. SRFA achieves similar overall and disease-free survival rates as surgical resection. SRFA challenges surgical resection as the first-line treatment for colorectal liver metastases.
authors.affiliation: Department of Microinvasive Therapy (SIP), Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. reto.bale@i-med.ac.at
authors.forename: Reto
authors.initials: R
authors.lastname: Bale
authors.forename: Gerlig
authors.initials: G
authors.lastname: Widmann
authors.forename: Peter
authors.initials: P
authors.lastname: Schullian
authors.forename: Marion
authors.initials: M
authors.lastname: Haidu
authors.forename: Georg
authors.initials: G
authors.lastname: Pall
authors.forename: Alexander
authors.initials: A
authors.lastname: Klaus
authors.forename: Helmut
authors.initials: H
authors.lastname: Weiss
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Raimund
authors.initials: R
authors.lastname: Margreiter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D017115:Catheter Ablation / Q000401:mortality*; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013238:Stereotaxic Techniques / Q000401:mortality*; D016896:Treatment Outcome
references.citation: J Vasc Interv Radiol. 2005 Dec;16(12):1727-35
references.pmid: 16371542
references.citation: N Engl J Med. 2004 Jun 3;350(23):2335-42
references.pmid: 15175435
references.citation: Colorectal Dis. 2003 Sep;5(5):515-7
references.pmid: 12925092
references.citation: Ann Surg. 2005 May;241(5):715-22, discussion 722-4
references.pmid: 15849507
references.citation: Ann Surg. 2002 Jun;235(6):759-66
references.pmid: 12035031
references.citation: Br J Surg. 1990 Nov;77(11):1241-6
references.pmid: 2253003
references.citation: Ann Surg. 1984 May;199(5):502-8
references.pmid: 6721600
references.citation: Ann Surg Oncol. 2007 Mar;14(3):1151-60
references.pmid: 17195913
references.citation: AJR Am J Roentgenol. 2000 Dec;175(6):1619-25
references.pmid: 11090390
references.citation: J Clin Oncol. 2010 Jan 20;28(3):493-508
references.pmid: 19841322
references.citation: Ann Surg. 2005 Aug;242(2):158-71
references.pmid: 16041205
references.citation: Ann Surg Oncol. 2008 Jan;15(1):227-32
references.pmid: 17882491
references.citation: J Gastrointest Surg. 2000 Mar-Apr;4(2):178-84
references.pmid: 10675241
references.citation: Acta Radiol. 2007 Apr;48(3):253-8
references.pmid: 17453491
references.citation: Invest Radiol. 2007 Mar;42(3):163-71
references.pmid: 17287646
references.citation: Eur Radiol. 2004 Dec;14(12):2261-7
references.pmid: 15599547
references.citation: Ann Surg. 1998 Apr;227(4):566-71
references.pmid: 9563547
references.citation: Eur J Surg Oncol. 2008 Mar;34(3):318-23
references.pmid: 18055158
references.citation: Ann Surg. 2004 Jun;239(6):818-25; discussion 825-7
references.pmid: 15166961
references.citation: J Gastrointest Surg. 2009 Mar;13(3):486-91
references.pmid: 18972167
references.citation: Cardiovasc Intervent Radiol. 2011 Aug;34(4):852-6
references.pmid: 20734193
references.citation: Cardiovasc Intervent Radiol. 2012 Jun;35(3):570-80
references.pmid: 21671150
references.citation: Radiology. 2001 Oct;221(1):159-66
references.pmid: 11568334
references.citation: Eur J Radiol. 2010 Jul;75(1):32-6
references.pmid: 20452738
references.citation: Eur J Cancer. 2006 Sep;42(14):2212-21
references.pmid: 16904315
references.citation: Int J Med Robot. 2010 Sep;6(3):343-9
references.pmid: 20632255