title: Short term and long term results of patients with colorectal liver metastases undergoing surgery with or without radiofrequency ablation.
abstract: OBJECTIVE
  The combination of resection and radiofrequency ablation (RFA) may provide an alternative treatment for patients with unresectable colorectal liver metastases (CRLM). Although the results in literature look promising, uncertainty exists with regard to complication risks and survival for this therapy.
  
  
  METHODS
  From January 2000 to May 2013, patients were included in a prospective multicenter database when treated for CRLM. Exclusion criteria were: two-staged treatment, synchronous resection of liver metastases and primary tumor, loss to follow-up or extrahepatic metastases. Patients were divided in a resection-only group (ROG) and combination group (CG). Outcome variables were retrospectively analyzed.
  
  
  RESULTS
  In CG, 98 patients were included versus 534 patients in ROG. There were no differences in general patient characteristics. Patients in CG had a higher Fong clinical risk score (CRS; P = 0.001), better ASA classification (P = 0.04) and received more neoadjuvant chemotherapy (P = 0.001). There was no difference in postoperative morbidity or 90-day mortality. The 5-year disease-free survival (DFS) for CG and ROG was 25% and 36.1% (P = 0.03), respectively. For the 5-year overall survival (OS) this was respectively 42% and 62.2% (P = 0.001). On multivariate analysis, Fong CRS was a significant predictor for DFS. For OS, Fong CRS, ASA class IV and the combination therapy were significant predictors.
  
  
  CONCLUSIONS
  The combination of hepatic resection and intraoperative RFA is a safe procedure, without increase in postoperative morbidity or mortality. Combining RFA and resection in one session is a valid treatment option for patients who would otherwise be inoperable.
authors: Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, The Netherlands. Electronic address: Martin.vanAmerongen@radboudumc.nl.
authors: M J
authors: MJ
authors: van Amerongen
authors: Department of Surgical Oncology, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, The Netherlands.
authors: E P
authors: EP
authors: van der Stok
authors: Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, The Netherlands; MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, PO Box: 217, 7500 AE, Enschede, The Netherlands.
authors: J J
authors: JJ
authors: Fütterer
authors: Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, The Netherlands.
authors: S F M
authors: SF
authors: Jenniskens
authors: Department of Radiology, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, The Netherlands.
authors: A
authors: A
authors: Moelker
authors: Department of Surgical Oncology, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, The Netherlands.
authors: D J
authors: DJ
authors: Grünhagen
authors: Department of Surgical Oncology, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, The Netherlands.
authors: C
authors: C
authors: Verhoef
authors: Department of Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, The Netherlands.
authors: J H W
authors: JH
authors: de Wilt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal neoplasms; Hepatectomy; Liver; Radiofrequency catheter ablation