Clinical

Resection rather than radiofrequency ablation best for colorectal liver metastasis

Last Updated: 2006-06-02 18:51:34 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Most patients who undergo hepatic resection (HR) of solitary colorectal liver metastasis conducted by proficient surgeons are still alive after 5 years, according to researchers. This is not the case after radiofrequency ablation (RFA).

As senior author Dr. Eddie K. Abdalla told Reuters Health, "this study emphasizes that the standard of care for treatment of colorectal liver metastasis is resection."

"Hepatic resection," he continued, "is safe in centers with experienced hepatobiliary surgeons, and outcomes following resection of solitary -- and multiple -- liver metastases continue to improve while less invasive treatment options do not yet exist that provide the curative potential of hepatic surgery."

Dr. Abdalla and colleagues at The University of Texas M. D. Anderson Cancer Center, Houston came to this conclusion after studying data on 180 patients who had solitary liver metastasis.

According to their report in the Archives of Surgery for May, none of the patients had had previous liver-directed therapy and this was the first site of metastasis. In all, 150 underwent HR and the remaining 30 received RFA. RFA was employed when resection would have removed too much tissue or because of comorbidity.

The local recurrence rate after HR was 5% compared to 37% in RFA patients. Corresponding rates for 5-year survival were 71% versus 27%, with 50% of the HR patients achieving disease-free 5-year survival versus none of the RFA patients.

Thus, concluded Dr. Abdalla, "referral to centers of excellence in hepatic surgery and multidisciplinary patient care will provide opportunities for long-term survival to an increasing proportion of patients with liver tumors."

Arch Surg 2006;141:460-467.