Radiofrequency Ablation as an Option to First Stage in Context of Two Stage Hepatectomy for CRLM

Abstract

A 70-year-old man with a medical history of Hypertension, Coronary Heart Disease, and Coronary Angioplasty. Diagnosed with differentiated tubular adenocarcinoma with liver metastasis (cT3N0M1 EC IVa). The liver metastases located in segments III, IV and VII. Initially submitted to video-assisted radical left colectomy with favorable evolution, in addition to adjuvant chemotherapy. New staging shows secondaryity limited to the liver, resection of the compromised segments supposed a future liver remnant of approximately 31%, for which two-stage liver resection is proposed. Due to comorbidities, the need for a short operating time and minimal bleeding, he underwent radiofrequency ablation of lesions in the left liver associated with ligation of the right portal vein. 12 weeks later, hypertrophy of the left liver was confirmed with a future liver remnant of 49%, without disease progression, completing the right hepatectomy. Control at 18 months without evidence of disease progression.