Radiofrequency ablation of colorectal liver metastases.

RFA of liver metastases is promising despite variable results. The differences in reported success rates may be explained by the difference in tumour types/vascularity/aggressiveness, patient selection, operator's expertise and the equipment used. Current limits relate to the small volume of consistent ablation that can be achieved with current equipment. Further technical refinements yielding more reliable ablation with larger surgical margin may reduce local recurrence rate. Although numerous studies have shown effective treatment responses after RFA, the precise impact of RFA on survival of colorectal cancer patients with liver metastases remains unclear. Resection remains the gold standard for patients with liver metastases. In patients with limited number of unresectable lesions and in cases, which are unresectable on the basis of lesional number and localization, RFA is an attractive approach to obtain tumour clearance. Randomised control trials evaluating the value of combined adjuvant systemic chemotherapy are still urgently needed.