Comparison of hepatic recurrences after resection or intraoperative radiofrequency ablation indicated by size and topographical characteristics of the metastases

Aims: Intraoperative use of radiofrequency ablation (IRFA) to treat liver metastases is controversial. The aim of this study was to compare local recurrence rate and survival after IRFA versus resection. Methods: Three groups from 99 patients were consecutively operated on for 307 liver metastases with 2 years of follow up: group 1, IRFA alone (n = 34); group 2, IRFA plus resection (n = 28); group 3, resection alone (n = 37). The choice of IRFA or resection was made on the basis of the sizes and topographies of the metastases with the goal of achieving R0 treatment. Results: Mortality was zero; morbidity was 9%, 11% and 11% in the three groups respectively. Median follow-up after surgery was 30 months. Total hepatic recurrences occurred in 59 (60%) patients. Median survival without hepatic recurrence was 17 months with no difference between the three groups (P = 0.474). Total local recurrence occurred in 4 (12%) patients in group 1, in 2 (8%) patients in group 2, and in 2 (6%) patients in group 3. Survival at 2 years was no different in the three groups. Conclusion: Assessing IRFA indications by size and the topographical characteristics of the liver metastases yields identical local recurrence rates to resection after 2 years of follow up. (C) 2007 Elsevier Ltd. All rights reserved.