BACKGROUND:Surgical resection is the gold standard in the treatment of resectable colorectal liver metastases (CRLM). In several centers, resection is being replaced by radiofrequency ablation (RFA), even though there is no evidence yet from randomized trials to support this. The aim of this study was to critically review the oncological evidence for and against the use of RFA for resectable CRLM. METHODS: An exhaustive review of RFA of colorectal metastases was carried out. RESULTS: Five-year survival data after RFA for resectable CRLM are not available. Percutaneous RFA is associated with worse local control, worse staging, and a small risk of electrode track seeding when compared with resection (level V evidence). For tumors </=3 cm, local control after surgical RFA is equivalent to resection, especially if applied by experienced physicians to nonperivascular tumors (level V evidence). There is indirect evidence for profoundly different biological effects of RFA and resection. CONCLUSIONS: A subgroup of patients has been identified for whom local control after RFA might be equivalent to resection. Whether this is true, and whether this translates into equivalent survival, remains to be proven. The time has come for a randomized trial.
RCT Entities:
BACKGROUND: Surgical resection is the gold standard in the treatment of resectable colorectal liver metastases (CRLM). In several centers, resection is being replaced by radiofrequency ablation (RFA), even though there is no evidence yet from randomized trials to support this. The aim of this study was to critically review the oncological evidence for and against the use of RFA for resectable CRLM. METHODS: An exhaustive review of RFA of colorectal metastases was carried out. RESULTS: Five-year survival data after RFA for resectable CRLM are not available. Percutaneous RFA is associated with worse local control, worse staging, and a small risk of electrode track seeding when compared with resection (level V evidence). For tumors </=3 cm, local control after surgical RFA is equivalent to resection, especially if applied by experienced physicians to nonperivascular tumors (level V evidence). There is indirect evidence for profoundly different biological effects of RFA and resection. CONCLUSIONS: A subgroup of patients has been identified for whom local control after RFA might be equivalent to resection. Whether this is true, and whether this translates into equivalent survival, remains to be proven. The time has come for a randomized trial.
Authors: Constantinos T Sofocleous; Elena N Petre; Mithat Gonen; Karen T Brown; Stephen B Solomon; Anne M Covey; William Alago; Lynn A Brody; Raymond H Thornton; Michael D'Angelica; Yuman Fong; Nancy E Kemeny Journal: J Vasc Interv Radiol Date: 2011-04-22 Impact factor: 3.464
Authors: Gianpiero Gravante; John Overton; Roberto Sorge; Neil Bhardwaj; Matthew S Metcalfe; David M Lloyd; Ashley R Dennison Journal: J Gastrointest Surg Date: 2011-02 Impact factor: 3.452
Authors: K S Lehmann; J P Ritz; S Valdeig; V Knappe; A Schenk; A Weihusen; C Rieder; C Holmer; U Zurbuchen; P Hoffmann; H O Peitgen; H J Buhr; B B Frericks Journal: Langenbecks Arch Surg Date: 2009-03-10 Impact factor: 3.445
Authors: S Ahmed; O Bathe; S Berry; D Buie; J Davies; C Doll; S Dowden; S Gill; V Gordon; P Hebbard; E Jones; H Kennecke; S Koski; M Krahn; D Le; H Lim; C Lund; Y Luo; A Mcffadden; J Mcghie; K Mulder; J Park; F Rashidi; A Sami; K T Tan; R Wong Journal: Curr Oncol Date: 2015-04 Impact factor: 3.677
Authors: Kai Siegfried Lehmann; Bernd Benedikt Frericks; Christoph Holmer; Andrea Schenk; Andreas Weihusen; Verena Knappe; Urte Zurbuchen; Heinz Otto Peitgen; Heinz Johannes Buhr; Jörg Peter Ritz Journal: Int J Colorectal Dis Date: 2011-03-15 Impact factor: 2.571