Besides conventional surgical resection (SRS) radiofrequency ablation (RFA) represents a new, alternative treatment option for patients with hepatic malignancies, such as hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM). With RFA, tumor tissue is destroyed by applying heat (80-110°C) that is delivered by electrodes and leads to a necrosis and local ablation of the tumor.

This systematic review aims at comparing the efficacy and safety of RFA and surgical resection for the treatment of both HCC and CRLM.

We conducted a systematic literature search in different databases and on various websites, which was complemented by an unsystematic handsearch, and yielded 327 references in total.

Overall, we identified eight studies that met our pre-defined inclusion criteria. Of those, five studies compared RFA with SRS for the treatment of HCC, two studies compared RFA with SRS for the treatment of CRLM and two studies presented information on single-arm RFA for the treatment of CRLM. The evidence indicates that compared to RFA SRS is superior in terms of 5-year-survival and recurrence for the treatment of both HCC and CRLM. However, following SRS of HCC mortality and morbidity rates are higher than after RFA of HCC. In addition, there is no evidence regarding the safety of RFA for the treatment of CRLM, neither from controlled trials, nor from case-series.