Nevertheless, because of unfavourable tumor location, inadequate hepatic

reserve or disease extent, only 20-40% of patients with CLM will be candidates for HR in the contemporary era (13,17). For patients who are not suitable for HR of CLM, several liver-directed therapies and adjuncts have been proposed to expand the indications for potentially curative therapy. Intraparenchymal ablative techniques, including Inhibitors,research,lifescience,medical radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation, have been widely studied (18). Unfortunately, high local recurrence rates of around 40% and the lack of long-term outcomes data have precluded the widespread adoption of these techniques (3,18,19). Many investigators have argued that ablation should only be used sparingly and restricted to patients with small lesions (3,20-23). Conversely, other investigators Inhibitors,research,lifescience,medical have proposed that ablation is effective, both as adjunct to HR or as an

isolated treatment option for patients with limited hepatic involvement or solitary metastases (17,24-29). Although significant efforts made by the surgical oncology community to define the role of ablation, further studies are necessary. Inhibitors,research,lifescience,medical In particular, although studies have shown that in patients with resectable disease, the outcomes of resection compared to combined resection and ablation are similar, there is significantly less comparative data for multiple lesions. Some studies included patients with extra-hepatic disease leading to confounding of the results to evaluate each treatment modalities. The aim of the current study was to evaluate the role of resection, combined resection and ablation Inhibitors,research,lifescience,medical and isolated ablation in the management of a large learn more number of patients with isolated CLM. More specifically, we sought to determine the influence of treatment type Inhibitors,research,lifescience,medical on outcomes for patients with 1-4 and ≥5 lesions, respectively. Patients and methods We reviewed the records of 701

consecutive patients with colorectal hepatic metastases without extra-hepatic disease who underwent hepatic intervention from a prospective Carnitine palmitoyltransferase II database. All procedures were performed at the Hepatobiliary Service of the University of New South Wales, Department of Surgery, St George Hospital between April 1990 and December 2010. All patients had previously diagnosed colorectal cancer and were treated with curative intent. Patients were evaluated with a baseline medical history, clinical examination, serum laboratory tests including the tumor marker carcinoembryonic antigen (CEA), computed tomography (CT) angiogram of the liver, whole body CT (chest, abdomen, and pelvis), and chest radiography. Patients who underwent open and close procedures without hepatic intervention for their tumor were excluded from this study.