11. Locoregional techniques for liver-limited metastatic colorectal cancer

Local destruction techniques for colorectal liver metastases, particularly radiofrequency, have been incorporated into clinical practice in the past 5 years. Only 10% to 25% of patients with colorectal hepatic metastases have tumours that are potentially resectable. Local techniques represent a chance of treatment in conjunction with resection or as a standalone procedure. It is difficult to compare ablation modalities. Results of studies examining these techniques are mostly restricted to reports of patient cases, which are often not presented in a standardised manner. Additionally, randomised controlled trials are rare. Radiofrequency is the most extensively studied treatment modality, and response rates and survival after radiofrequency therapy have been established. Cryoablation and microwave ablation are employed in the same clinical setting as radiofrequency, but have less favorable safety profiles. Other local ablation techniques such as electrolysis, chemoembolization or high-intensity focused ultrasound are under development for colorectal liver metastases. Radioembolization and hepatic arterial Correspondence/Reprint request: Dr. Virginia Arrazubi, Department of Medical Oncology, Hospital de Basurto Bilbao, Spain. E-mail: [email protected] Virginia Arrazubi et al. 264 chemotherapy should be considered as therapeutic options for patients who are not candidates for resection or radiofrequency.