A 10-year study by Dr. Siperstein and colleagues at Cleveland Hospital showed that radiofrequency ablation (RAF) prolongs long-term survival in patients with colorectal cancer liver metastases, with survival rates of 20.2% and 18.4% at 3 and 5 years, respectively. (Annals of Surgery. 2007, 246:559) The 234 patients with liver metastases from colorectal cancer enrolled in the study were unsuitable for resection and had failed chemotherapy prior to radiofrequency ablation. Without other treatment, their 5-year survival rate was almost zero. This is the largest and longest follow-up study to date of radiofrequency ablation for patients with liver metastases from colorectal cancer. Colorectal cancer ranks third in mortality due to cancer in the United States, with more than 53,000 deaths in 2007 and more than 150,000 new diagnoses each year. 25 percent of colorectal cancer patients develop liver metastases within 5 years, and only 8 to 27 percent of patients are suitable for surgery. The results of this study confirm the value of radiofrequency ablation in the treatment of patients with liver metastases from colorectal cancer who are not candidates for surgery. In this study, patients had a mean of 2.8 lesions and a mean lesion size of 3.9 cm (1.1 to 10.2 cm). Patients underwent radiofrequency ablation in the eighth month after the start of chemotherapy. The results showed that patients who underwent radiofrequency ablation had a mean survival of 24 months after treatment, compared with 12 to 15 months in the control group. Approximately 24% of enrolled patients had extrahepatic disease, but the presence of extrahepatic disease did not negatively affect survival. The researchers also explored the factors that affected patient survival. The results showed that patients with d “3 metastatic lesions had prolonged median survival compared with patients with >3 metastatic lesions (17 months vs. 27 months, P=0.003); there was no difference in median survival between those with lesions >3 cm and <3 cm (20 months vs. 28 months, P=0.07); and compared with those with carcinoembryonic antigen (CEA) >200 ng/ml, those with CEA <200 ng/ ml had prolonged median survival compared to those with CEA<200ng/ml (16 months vs. 26 months, P=0.003); neither extrahepatic lesions nor the type of pre/postoperative chemotherapy had any effect on median survival. Therefore, . The number and size of metastatic foci, as well as preoperative CEA values, are strong predictors for evaluating patient survival.