Thermal ablation as effective as surgery for small colorectal liver metastases

MedNet.nl: Thermal ablation as treatment for small colorectal liver metastases is not inferior to surgery. The Dutch COLLISION study shows that. Using ablation instead of surgery could reduce the number of complications, shorten hospital stays, and improve local control, the researchers say. The phase 3 COLLISION study was an initiative of the Dutch Colorectal Cancer Group. For the study, 342 patients with previously untreated colorectal carcinoma with up to 10 small liver metastases (≤3 cm) were randomized to two groups. The participants did not have metastases in other organs. One group received mainly thermal ablation as treatment for colorectal liver metastases (n=148) and in the other group the metastases were surgically resected (n=148). The primary outcome measure of the study was overall survival (OS). Due to the achievement of pre-established criteria indicating significant benefit from ablation, the study was stopped midway. After a median follow-up of 28.8 months, there was no difference in terms of OS (HR=1.051). In the group treated with surgery, three patients died compared with one patient in the group treated with thermal ablation, but this death was probably not related to ablation. Other endpoints also showed a benefit of using thermal ablation. For example, patients spent less time in the hospital after ablation (median 4 vs 1 day) and there were fewer untreatable local recurrences in these patients. There were no differences in terms of local tumor PFS and occurrence of distant metastases. Adverse events occurred in the operated and ablation-treated groups in 46% and 19%, and serious adverse events occurred in 20% and 7% of patients, respectively. The researchers conclude that the use of thermal ablation as standard care for small colorectal liver metastases can reduce complications without shortening disease-free and overall survival. Meijerink MR, Van der Lei S, Dijkstra M, et al. Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial. ASCO 2024, abstract LBA3501. This article was originally published in Dutch on MedNet.nl

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Thermal ablation as effective as surgery for small colorectal liver metastases

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