Combined resection and radiofrequency ablation for advanced hepatic malignancies: Results in 172 patients

Timothy M. Pawlik, Francesco Izzo, Deborah S. Cohen, Jeffery S. Morris, Steven A. Curley

Research output: Contribution to journalArticlepeer-review

253 Scopus citations


Background: Resection combined with radiofrequency ablation (RFA) is a novel approach in patients who are otherwise unresectable. The objective of this study was to investigate the safety and efficacy of hepatic resection combined with RFA. Methods: Patients with multifocal hepatic malignancies were treated with surgical resection combined with RFA. All patients were followed prospectively to assess complications, treatment response, and recurrence. Results: Seven hundred thirty seven tumors in 172 patients were treated (124 with colorectal metastases; 48 with noncolorectal metastases). RFA was used to treat 350 tumors. Combined modality treatment was well tolerated with low operative times and minimal blood loss. The postoperative complication rate was 19.8% with a mortality rate of 2.3%. At a median follow-up of 21.3 months, tumors had recurred in 98 patients (56.9%). Failure at the RFA site was uncommon (2.3%). A combined total number of tumors treated with resection and RFA >10 was associated with a faster time to recurrence (P = .02). The median actuarial survival time was 45.5 months. Patients with noncolorectal metastases and those with less operative blood loss had an improved survival (P = .03 and P = .04, respectively), whereas radiofrequency ablating a lesion >3 cm adversely impacted survival (HR = 1.85, P = .04). Conclusions: Resection combined with RFA provides a surgical option to a group of patients with liver metastases who traditionally are unresectable, and may increase long-term survival.

Original languageEnglish (US)
Pages (from-to)1059-1069
Number of pages11
JournalAnnals of Surgical Oncology
Issue number9
StatePublished - 2003
Externally publishedYes


  • Hepatocellular cancer
  • Liver metastases
  • Radiofrequency ablation
  • Resection

ASJC Scopus subject areas

  • Surgery
  • Oncology


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