Colorectal Cancer (CRC) ranks fourth in cancer deaths worldwide. Between 20% and 30% of patients with advanced CRC have Liver Metastases. Liver cancer ranks second in cancer deaths worldwide, including hepatocellular carcinoma. Despite recent advances, liver resection offers the only chance of cure for patients with liver metastases and liver cancer. However, the local recurrence rate of these liver tumours is high even after resection.The presence of positive (with malignant cells) margins in the remaining liver after resection correlates with increased local recurrence and decreased overall survival. So this is the only factor where expectation of survival could be influenced by the performance of surgery.
LIVERATION is an ambitious, pragmatic multicenter clinical trial in 7 different countries and 24 Hospitals to determine whether additional Radiofrequency ablation of tumor margin after liver surgery to resect cancer, can decrease the cancer recurrence rate and improve patient survival. Radiofrequency is a high-frequency alternating polarity, where electrical current is applied to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. Its benefits include the ability to make precise cuts with limited blood loss and its ability to deeply coagulate the tissue. Radiofrequency devices are frequently used during surgical operations helping to prevent blood loss in hospital operating rooms and its indications are being investigated and enlarged each year.
Currently, there are radiofrequency ablation studies that, based on preliminary retrospective human clinical studies, able to correlate an additional coagulation of tumor margins with a reduction on local recurrence. However, there is no prospective and controlled or comparative trial that accurately measures this additional margin and its impact on oncological outcomes. We hope to confirm this expectation with LIVERATION.
