A Comparison of the Initial Cost Associated with Resection Versus Laparoscopic Radiofrequency Ablation of Small Solitary Colorectal Liver Metastasis

Introduction: The aim of this report was to perform a cost-comparison between liver resection (LR) and radiofrequency ablation (RFA). Method: Patients with colorectal liver metastasis (CRLM)≤3 cm, who underwent LR or laparoscopic RFA between 2006 and 2015 were included in the study. Using a prospectively maintained CRLM database, clinical, oncologic, and financial parameters were compared. Results: Sixty-three patients underwent open or laparoscopic LR, and 25 patients underwent laparoscopic RFA. No significant difference was noted in postoperative complications, readmission rate, and local recurrence rate. With a median follow-up of 40 months for RFA, and 36 months for LR (P=0.61), mean cancer-specific overall survival was 51 months for RFA and 63 months for LR (P=0.64). The median disease-free survival was 14 months for RFA, and 21 months for LR (P=0.59). The mean operating room and hospital costs were 51% and 55% higher in the LR (P<0.001, each). Conclusions: The results of the study suggest that in selected patients with small solitary CRLM, laparoscopic tumor ablation might offer opportunities for cost-savings compared with resection as the primary treatment. This model may suggest possible equivalent oncologic outcomes between the 2 modalities.