Radiofrequency ablation or resection for small colorectal liver metastases - a plea for caution

Colorectal cancer (CRC) is among the leading causes for cancer death worldwide (1) and remains a serious problem for the public healthcare systems due to continuously growing costs of the treatment, and relatively low cure rates, especially in advanced stages of disease. The liver is secondary only to lymph nodes as a site for metastasis from primary CRC - about 50% of the patients developed liver metastases (CLM) during their course of disease, and in approximately ¾ of these the liver is the only site of distant spread (2). To date, resection of the metastases (LR) is the only proven potentially curative treatment option for the patients with CLM. However, despite the current advances in the concepts and techniques in liver surgery, the vast majority of the patients with CLM as well as those with other liver malignancies are not amenable to curative surgery.