Thermal ablation is safer than resection of colorectal liver lesions

Abstract

Surgical resection is the standard of care for patients with colorectal liver metastases. Thermal ablation has emerged as an alternative management approach for small lesions (≤3 cm diameter), although how it compares with surgery is unclear because most of the available evidence is from meta-analyses of retrospective studies. Now, results from the phase III COLLISION trial demonstrate that thermal ablation results in noninferior efficacy outcomes and has a superior safety profile relative to resection.

In this trial, 296 patients with colorectal liver metastases were randomly allocated (1:1) to undergo thermal ablation or resection of all target lesions (median 2, range 1–10). Of note, 18% and 35% of patients in the thermal ablation and resection groups, respectively, underwent both approaches. Overall survival (OS) was the primary end point.