A systematic review on the clinical benefit and role of radiofrequency ablation as treatment of colorectal liver metastases

Aim: To evaluate the role of radiofrequency ablation (RFA) as treatment of colorectal cancer liver metastases (CLMs). Method: A PubMed literature search for original articles published until August 2008 was performed. Studies with >= 40 patients, >= 18 month median follow-up and reported >= 3 year overall survival (OS) rates after RFA of CLM were selected for analysis. Results: Thirteen clinical series and 8 non-randomised comparative studies were analysed. Median progression free survival after RFA ranged between 6 and 13 months. Median and 5-year OS after RFA (RFA plus resection) ranged between 24-59 months and 18-40% (3646 months and 27-30%). Comparative studies indicated significantly improved OS after RFA versus chemotherapy alone, RFA plus chemotherapy versus RFA alone and up-front RFA versus RFA following second-line chemotherapy. Conclusion: Our findings support that RFA prolongs time without toxicity and survival as an adjunct to hepatectomy and/or chemotherapy in well-selected patients, but not as an alternative to resection. (C) 2009 Elsevier Ltd. All rights reserved.