We investigated efficacy of microwave ablation plus hepatectomy for multiple colorectal liver metastases. Clinicopathologic data were analyzed retrospectively for 97 consecutive patients with 4 or more bilobar liver metastases from colorectal cancer who underwent hepatectomy with or without microwave ablation. No significant differences were found for overall and disease-free survival between 26 patients with resection/ablation and 71 patients with resection (p = 0.68 and 0.60). Local liver recurrence occurred in 1 patient with combined resection/ablation, but no significant difference of liver recurrence pattern was observed between groups. In patients with combined resection/ablation, survival was significantly greater in prehepatectomy chemo-responders associating with less frequent microscopic cancer deposits surrounding liver metastases than in nonresponders. Microwave ablation plus hepatic resection expanded indications for surgery to treat multiple bilobar liver metastases without loss of survival efficacy, especially in prehepatectomy chemo-responders.
