RFA of CRLMs is a safe procedure with low rates of local relapses and recurrences, as well as acceptable survival rates, in the first 24-36 months post-procedure. It is recommended for patients with no indications for liver resection or having major resection risks.

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Management of synchronous colorectal cancer with liver metastases (SCLM) is still on debate, regarding timing, indications and complications of the 3 strategies: classic approach (first tumor resection), simultaneous resection and reverse approach (liver first). A retrospective single-centre evaluation of synchronous approach was accomplished, focusing on surgical technique, indications and perioperative complications. Between 2017 and 2020, 31 SCLM patients benefited from synchronously colorectal and hepatic approach: segmental colectomies/rectal resections, simultaneously with liver metastasectomies (associated with radiofrequency ablation). Post-therapeutic imaging monitoring was performed from every 3 to 6 months. There were no perioperative complications related to the combination of the two procedures, low morbidity and zero postoperative mortality. The follow-up period was from 10 to 40 months: 13 patients had no evidence of recurrence, 10 patients had hepatic metastases in regression, 4 of them had signs of peritoneal carcinomatosis and 4 patients showed progression of liver disease; all patients were on chemotherapy. During follow-up 4 patients died. Experience shows that the simultaneous approach of recto-colic and hepatic resections in colo-rectal cancers is a safe procedure, with low morbidity, the limits being dictated by the size of the liver metastases. The results at long-distance must be drawn by further consistent trials.