Solitary Small Colorectal Liver Metastasis: Hepatic Resection or Radiofrequency Ablation?

Case report


Ehtuish F. Ehtuish1, Anuj Mishra 2, Taib Shawish 1, Ahmed Usta 1, Ali Aboutwerat 3, Tamer AbdElmola 2.

1-Departments of Surgery, 2-Departments of Radiology, 3-Departments of Hepatology National Organ Transplant Programme, Tripoli Central Hospital, Tripoli, Libya

JMJ 2009,Vol.9, No.3: 229-233


Objective: Hepatic resection and radiofrequency ablation (RFA) have been proposed as equivalent treatments for colorectal liver metastasis and small hepatocellular carcinoma (HCC). Our aim was to assess the efficacy and safety of RFA of solitary small <3 cm colorectal liver metastasis. Methods & Materials: Two patients with documented cancer colon and solitary liver metastasis were selected for percutaneous RFA treatment. Both the patients had < 3cm liver lesion. There were no contraindications to the procedure such as vascular invasion, capsular infiltration or disseminated pleuro-peritoneal disease. Ultrasound-guided single-session RFA was administered to both the patients under general anaesthesia and follow-up triphasic CT scans were performed after 24 hours, one month and one year of treatment. Results: Both the patients showed complete tumour necrosis after the RFA treatment in the 24 hour post-RFA scan. The follow up scans after one month and one year did not show any evidence of viable tumour tissue. There were no post-procedural complications. Both the patients were declared cured. No other fresh liver lesion was detected on follow-up scans. Conclusion: RFA is cost-effective and has a local complete response rate similar to that after resection in solitary small < 3cm colorectal liver metastasis. HCC, hence, saves the patient from major surgery such as hepatic resection. Keywords: Radiofrequency ablation, Hepatocellular carcinoma, Colorectal liver metastasis, Surgical resection. Link/DOI: