title: [Radiofrequency ablation for treatment of colorectal liver metastases: scientific evidence and clinical reality].
abstract: Radiofrequency ablation (RFA) of colorectal liver metastases is frequently reported, but, however, lacks clear criteria for indication and reliable, convincing results with 5-year survival ranging from 17 to 48 %. RFA may be the appropriate treatment modality in approximately 3 to 5 % of all patients suffering from colorectal liver metastases. To date, RFA seems to be limited to no more than three metastases, each smaller than 3 cm. The main indication remains irresectability due to number, site, distribution and/or marginal liver function. Tumours in the vicinity of larger vessels (predominantly branches of portal or hepatic veins) are a case for controversy, since advances in hepatobiliary surgery enable a proportion of patients to undergo resections which would have been declared irresectable until most recently, and the oncological value of a thermoablation is questioned, as a certain amount of temperature is lost due to convective heat sinks. RFA is not a curative alternative to hepatic resection unless small tumours appear during open or laparoscopic procedures in a patient with elevated risk for early recurrence or postoperative morbidity following liver resection. The inclusion of RFA into a holistic system of oncological therapy is mandatory. Early RFA followed by systemic (regional?) chemotherapy can rather be recommended than chemo only, RFA only or first-line chemo with subsequent RFA.
authors.affiliation: Allgemein-, Viszeral-, Gefäß- & Kinderchirurgie, Universitätsklinik des Saarlandes, Homburg, Deutschland.
authors.forename: R M
authors.initials: RM
authors.lastname: Eisele
authors.affiliation: Allgemein-, Viszeral- & Transplantationschirurgie, Charité Campus Virchow-Klinikum, Berlin, Deutschland.
authors.forename: S S
authors.initials: SS
authors.lastname: Chopra
authors.affiliation: Diagnostische und Interventionelle Radiologie, Universitätsklinik des Saarlandes, Homburg, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Kubale
authors.affiliation: Allgemein-, Viszeral-, Gefäß- & Kinderchirurgie, Universitätsklinik des Saarlandes, Homburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Glanemann
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D015996:Survival Rate; D016896:Treatment Outcome