title: Local recurrence rates after radiofrequency ablation or resection of colorectal liver metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983.
abstract: OBJECTIVE
  The aim of this study is to describe local tumour control after radiofrequency ablation (RFA) and surgical resection (RES) of colorectal liver metastases (CLM) in two independent European Organisations for Research and Treatment of Cancer (EORTC) studies.
  
  
  BACKGROUND
  Only 10-20% of patients with newly diagnosed CLM are eligible for curative RES. RFA has found a place in daily practice for unresectable CLM. There are no prospective trials comparing RFA to RES for resectable CLM.
  
  
  METHODS
  The CLOCC trial randomised 119 patients with unresectable CLM between RFA (±RES)+adjuvant FOLFOX (±bevacizumab) versus FOLFOX (±bevacizumab) alone. The EPOC trial randomised 364 patients with resectable CLM between RES±perioperative FOLFOX. We describe the local control of resected patients with lesions ≤4 cm in the perioperative chemotherapy arm of the EPOC trial (N=81) and the RFA arm of the CLOCC trial (N=55).
  
  
  RESULTS
  Local recurrence (LR) rate for RES was 7.4% per patient and 5.5% per lesion. LR rate for RFA was 14.5% per patient and 6.0% per lesion. When lesion size was limited to 30 mm, LR rate for RFA lesions was 2.9% per lesion. Non-local hepatic recurrences were more often observed in RFA patients than in RES patients, 30.9% and 22.3% respectively. Patients receiving RFA had a more advanced disease.
  
  
  CONCLUSIONS
  LR rate after RFA for lesions with a limited size is low. The local control per lesion does not appear to differ greatly between RFA and surgical resection. This study supports the local control of RFA in patients with limited liver metastases. Future studies should evaluate in which patients RFA could be an equal alternative to liver resection.
authors.affiliation: EORTC Headquarters, Brussels, Belgium. Electronic address: eriktanis@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Tanis
authors.affiliation: Department of Surgery, Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hopitaux de Paris, Boulogne-Billancourt, France.
authors.forename: B
authors.initials: B
authors.lastname: Nordlinger
authors.affiliation: Department of Statistics, EORTC Headquarters, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Mauer
authors.affiliation: Department of Oncology, Haukeland University Hospital, Bergen, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Sorbye
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: van Coevorden
authors.affiliation: Department of Surgery, Medical University Vienna, Vienna, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Gruenberger
authors.affiliation: Department of Surgery, Robert-Roessle-Klinik, Humboldt-Universitat Berlin, Berlin, Germany.
authors.forename: P M
authors.initials: PM
authors.lastname: Schlag
authors.affiliation: Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: C J A
authors.initials: CJ
authors.lastname: Punt
authors.affiliation: UCL and UCL Hospitals Comprehensive Biomedical Research Centre, University College London, London, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Ledermann
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands.
authors.forename: T J M
authors.initials: TJ
authors.lastname: Ruers
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D017115:Catheter Ablation; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil
keywords: Colorectal liver metastases; Local recurrence; Radiofrequency ablation; Resection