[Radiofrequency ablation of colorectal metastases to the liver: results since the first application in the Netherlands].

Objective.To provide an overview of the morbidity, mortality and survival following the introduction ofradiofrequency ablation (RFA) ofcolorectal liver metastases in the Netherlands. Design. Prospective, descriptive study. Method. Between June 1999 and December 2003 in eight hospitals in the Netherlands, 87 patients treated by RFA for colorectal liver metastases were included in the study. The outcome measures were morbidity, 30-day mortality and the percentage local recurrence. Results. In 104 RFA procedures, 199 metastases were ablated; 31 procedures were performed percutaneously and 73 by laparotomy. In 29 procedures, RFA was combined with partial liver resection. The overall postoperative morbidity rate was 19% and the RFA-related morbidity was 14%. I patient died following right hemihepatectomy and RFA in the remaining parenchyma (mortality: I%). Median survival following RFA was 25 months, with a median progression-free survival of 13 months. The overall local recurrence rate was 46%. Since January 2004, this percentage has decreased to approximately 6. Diameter and central location ofthe metastases were independent risk factors for the development of a local recurrence. Conclusion. RFA is an alternative treatment for patients who are not eligible for partial liver resection. The high local recurrence rate in this series reflects the limited experience with this technique during its introduction in the Netherlands. In specialised centres the percentage local recurrence is now 5. Treatment by RFA should always be weighed against the option of partial liver resection and possible (neoadjuvant) chemotherapy. RFA should therefore preferably be carried out in a centre with expertise in the field of liver surgery.