title: Long-term outcomes following tumor ablation for treatment of bilateral colorectal liver metastases.
abstract: OBJECTIVE
  Ablative therapies extend the capability of delivering potentially curative treatment for bilateral hepatic colorectal metastases.
  
  
  OBJECTIVE
  To compare the long-term effectiveness of ablation with that of resection in patients with bilateral hepatic colorectal metastases.
  
  
  METHODS
  Review of a prospective database of 2123 operative cases of hepatic colorectal metastases.
  
  
  METHODS
  A large institution with expertise in ablation and resection.
  
  
  METHODS
  Patients with bilateral colorectal liver metastases undergoing operation with a curative intent. A total of 141 patients had been treated with bilateral resection (BR) and 95 had undergone ablation.
  
  
  METHODS
  Radiofrequency or microwave ablation alone or in combination with resection (A/R) compared with BR.
  
  
  METHODS
  We compared tumor characteristics and operative and postoperative outcomes using χ2 or Wilcoxon tests as appropriate and assessed overall survival differences between the 2 groups using the log-rank test.
  
  
  RESULTS
  During the study, 141 patients were treated with BR and 95 patients with A/R. The A/R group was a significantly poorer prognostic group than the BR group as judged by the Clinical Risk Score (P < .01). There was no difference in median operative time (A/R: 280 minutes, BR: 282 minutes; P = .52), but a lower blood loss (A/R: 300 mL, BR: 500 mL; P < .01) and a shorter length of stay (A/R: 7 days, BR: 9 days; P < .01) was achieved in the A/R group. Long-term outcome was not significantly different between the groups (5-year overall survival, A/R: 56%, BR: 49%; P = .16).
  
  
  CONCLUSIONS
  Treatment of bilateral, multiple hepatic metastases with combined resection and ablation was associated with improved perioperative outcomes without compromising long-term survival compared with bilateral resection. Ablative therapies extend the capability of delivering potentially curative treatment for bilateral hepatic colorectal metastases.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Karanicolas
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.forename: Mithat
authors.initials: M
authors.lastname: Gonen
authors.forename: Scott
authors.initials: S
authors.lastname: Tuorto
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Allen
authors.forename: Ronald P
authors.initials: RP
authors.lastname: DeMatteo
authors.forename: Michael I
authors.initials: MI
authors.lastname: D'Angelica
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome