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

Abstract 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.