Intraoperative local ablative therapies combined with surgery for the treatment of bilobar colorectal liver metastases

Abstract

Aim: To investigate the role of intraoperative local ablation techniques (LATs) in bilobar colorectal liver metastases (bCRLM). Patients and Methods: Among patients who underwent LAT for CRLM between 2005 and 2015, we selected 33 patients with bilobar disease submitted to thermal ablation alone or associated to liver resection. Primary end-point was complete local response at one month (CLR). Secondary end-points were morbidity, mortality, disease-free survival (DFS), local tumor recurrence (LTR) and long-term survival. Results: CLR was observed in 100% of cases, while LTR occurred in 8 cases (22%). DFS at 1, 3 and 5 years was 37%, 5% and 5%. Overall survival (OS), in the same interval, was 95%, 49% and 26%. Univariate analysis found a significant correlation between LTR and tumor size (11% ≤20 mm vs. 50% >20 mm; p=0.009). Conclusion: LAT is an effective adjuvant strategy in bCRLM for nodules within 20 mm diameter.