Ablative Techniques for Colorectal Cancer Liver Metastases

The use of extreme temperatures to treat tumors dates back over a century [1]. However, in parallel with the dramatic evolution of liver surgery, the last three decades have seen an accelerated expansion of techniques and indications for liver tumor ablation, and they are currently considered complementary strategies in the treatment of primary and secondary liver malignancies. Moreover, ablation has become an accepted alternative to hepatic resection in a select group of patients with both primary and metastatic liver neoplasms. Indications for ablative therapies include patients considered unfit for surgery due to either location of the lesion or poor health, those with smaller lesions, or those in whom a small amount of remnant liver parenchyma precludes resection [2, 3]. These techniques have also been advocated as a bridge to transplantation in patients facing a long waiting list for a liver allograft [4, 5].