[Ablative Modalities in the Treatment of Liver Metastases]. / Ablative Verfahren in der Therapie von Lebermetastasen.

ABSTRACT

In the absence of extrahepatic metastases, improved survival can be achieved with surgical and interventional techniques. In resectable patients the resection of liver metastases can be performed in curative intention. Interventional techniques are defined either as percutaneous or intraoperative laparoscopy, applications of thermal ablation. In this review, we concentrate on the most established ablative techniques of radiofrequency ablation (RFA) and microwave ablation (MWA) for the treatment of colorectal liver metastases. These techniques allow safe ablation of metastases of up to 3 cm and have a low complication rate. In the current recommendations and guidelines, interventional therapies can be used for tumours that are surgically difficult to resect, in combination with surgery to reduce the surgical trauma or - in case of recurrent metastases - to avoid complicated repeat surgeries. Interventional therapies in combination with chemotherapy are superior to chemotherapy alone and should be considered especially in irresectable situations.