Colorectal Hepatic Metastases: Role of Radiofrequency Ablation

Introduction: Radiofrequency ablation (RFA) is a new minimally invasive treatment that has been increasingly used in the treatment of liver metastases. This review aims to outline the principles governing the use of RFA and to examine its role when applied to the management of colorectal liver metastases. Methods: A Medline search of experimental and clinical studies relating to the use of RFA in the management of colorectal hepatic metastasis was carried out. Results: RFA is currently used as an alternative to surgery in patients with unresectable disease, and sometimes as its companion, allowing patients hitherto considered unsuitable for resection to become surgical candidates. RFA has been shown to be safe and well tolerated, with few major complications and minimal patient discomfort. Although its use is unlikely to achieve cure in such patients, it has a definite role in palliation and relief of symptoms. Long-term data, when these become available, may also show improved survival. However, because RFA is a local ablative therapy, it does not address the progressive and systemic nature of colorectal carcinoma. Conclusions: RFA is an important alternative/complimentary tool in the management of colorectal hepatic metastases. Combining RFA with surgery or chemotherapy may reduce the incidence of local and systemic relapse.