title: Safety and Efficacy of Ultrasound-Guided Radiofrequency Ablation of Recurrent Colorectal Cancer Liver Metastases after Hepatectomy.
abstract: BACKGROUND
  To assess the results and outcome of radiofrequency ablation in the treatment of recurrent colorectal liver metastases.
  
  
  METHODS
  Between January 2005 and September 2012, we treated 59 patients with recurrent colorectal metastases not amenable to surgery with 77 radiofrequency ablation procedures. Radiofrequency was indicated if oncologic resection was technically not possible or the patient was not fit for major surgery. A total of 91 lesions were treated. The mean number of liver tumors per patient was 1.5, and the mean tumor diameter was 2.3 cm. In 37.5% of the cases, lesions had a subcapsular location, and 34% were close to a vascular structure.
  
  
  RESULTS
  The morbidity rate was 18.7%, and there were no post-procedural deaths. Distant extrahepatic recurrence appeared in 50% of the patients. Local recurrence at the site of ablation appeared in 18% of the lesions. Local recurrence rate was 6% in lesions less than 3 cm and 52% in lesions larger than 3 cm. The size of the lesions (more than 3 cm) was an independent risk factor for local recurrence (p < 0.05). Survival rates at 1, 3, and 5 years were 94.5%, 65.3%, and 21.7%, respectively.
  
  
  CONCLUSIONS
  Radiofrequency ablation is a safe procedure and allows local tumor control in lesions less than 30 mm (local recurrence of 6%) and provides survival benefits in patients with recurrent colorectal liver metastases.
authors.affiliation: Department of Radiology, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain Department of Radiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden carlos.valls-duran@karolinska.se.
authors.forename: C
authors.initials: C
authors.lastname: Valls
authors.affiliation: Department of Surgery, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ramos
authors.affiliation: Department of Radiology, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Leiva
authors.affiliation: Department of Radiology, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Ruiz
authors.affiliation: Department of Radiology, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Martinez
authors.affiliation: Department of Surgery, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rafecas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Radiofrequency ablation; colorectal carcinoma; liver metastases; liver resection; local recurrence; ultrasonography