title: Laparoscopic radiofrequency ablation for the management of colorectal liver metastases: 10-year experience.
abstract: BACKGROUND
  Published results addressing the treatment of colorectal liver metastases (CRLM) with radiofrequency ablation (RFA) vary widely with local recurrence rates of 2-40% and 5-year survival of 14-55%. The goal of this study was to analyze our 10-year experience with laparoscopic RFA.
  
  
  METHODS
  From January 2000 to July 2010, 130 patients underwent laparoscopic RFA for CRLM. Kaplan-Meier analysis was used to assess survival. Univariate and multivariate analysis were performed to identify factors associated with survival and recurrence.
  
  
  RESULTS
  In this cohort, median survival was 40.4 months with 5-year survival of 28.8%. Overall, 9.2% of patients had a local recurrence (3.6% for tumors 3 cm or less). On univariate analysis, factors associated with decreased survival were BMI (P = 0.045), rectal primary (P = 0.005), and increased tumor size (P = 0.002). On multivariate analysis, increased tumor size (HR 1.29 [95% CI: 1.04-1.59]; P = 0.020) and bilobar disease (HR 2.06 [95% CI: 1.02-4.15]; P = 0.044) were associated with decreased survival. On univariate analysis, only BMI was found to be associated with disease recurrence (P = 0.025).
  
  
  CONCLUSIONS
  Our data demonstrate that laparoscopic RFA can achieve a median survival of 40.4 months with a low local recurrence rate. Patients with tumors 3 cm or less have a decreased risk of local recurrence.
authors.affiliation: Department of Surgery, Montefiore Medical Center, New York City, NY, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Kennedy
authors.forename: Maria A
authors.initials: MA
authors.lastname: Cassera
authors.forename: Yashodhan S
authors.initials: YS
authors.lastname: Khajanchee
authors.forename: Tayyab S
authors.initials: TS
authors.lastname: Diwan
authors.forename: Chet W
authors.initials: CW
authors.lastname: Hammill
authors.forename: Paul D
authors.initials: PD
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015992:Body Mass Index; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology*; D016208:Databases, Factual; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009519:New York City / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome