Optimizing treatment of hepatic metastases from colorectal cancer by resection, radiofrequency ablation or in combination: multi-institutional analysis

BACKGROUND: Traditionally multiple bilobar colorectal liver metastases (CRLM) were not considered suitable for radical surgical resection. Only 25% of patients presenting with CRLM are amenable to resection. The use of novel adjuncts to hepatic resection to aid tumour clearance is increasing. We sought to determine the efficacy of combined resection and ablation for CRLM. METHODOLOGY:Between January 1994 and December 2014, 360 patients underwent surgery for CRLM, were queried from an international multi-institutional database. There were 280 Patients who underwent hepatic resection only (Group 1) and 80 hepatic resection and RFA (Group 2). RESULTS: The median number of resected lesions were 3; the median number of thermoablated lesions were 2. Postoperative complications were similar in the two groups and mortality was nil. Five years OS was 48,6% and 80% For Group 1 vs Group 2 respectively (p= 0193). For patients undergoing R0 surgery DFS was 34% Vs 50% At 3 years (p= 0,96). CONCLUSION: Combined resection and ablation is associated with long-term survival in a subset of patients, and represents a potentially curative treatment option for patients with multiple bilobar hepatic metastases.