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

AimTo evaluate the role of radiofrequency ablation (RFA) as treatment of colorectal cancer liver metastases (CLMs).MethodA 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.ResultsThirteen 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% (36–46 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.ConclusionOur 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.