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Local Recurrence of Colorectal Liver Metastases after Radiofrequency Ablation compared to Local Surgery

(2012) Dimmendaal, M. (Marieke)

Introduction:
Coloncarcinoma is in the top three of malignancies in the Netherlands, and liver is the most common site of metastatic disease. Two of the treatment possibilities of liver metastases are local surgery and local radiofrequency ablation (RFA). Until now, the recurrence rate of either of these techniques is not entirely clear in the local situation of the Deventer Hospital.
Methods:
We performed a retrospective comparison of the recurrence free period of liver metastases treated with either local surgery (metastasectomy, 1 or 2 segment resection) or RFA. We designed a database on a per lesion basis in order to focus on differences in tech-niques and not on patient survival characteristics.
Results:
In a retrospective analysis from September 2005 until July 2012, 69 patients were included with a total number of 162 liver metastases with a median follow up time of 569 days. In the RFA treated metastases 24.6% (15 out of 61) showed recurrence after a median recurrence free period of 384 days. In surgically treated metastases, this was 2.0% (2 out of 101) after 640 days, respectively (Kaplan Meier p<0,001). Age, gender, extrahepatic metas-tases, chemotherapy, nor size of the metastasis before treatment were associated with tu-mour recurrence.
Conclusion:
In conclusion, local surgery is the preferred treatment technique option of liver metastases in colon carcinoma when compared to RFA when both methods are applicable. Further study is needed to investigate the effect on patient prognosis, and to investigate the
use of RFA in a combined setting with surgery (both local and extensive).





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