Thermal Ablation or Hepatic Resection for Limited Colorectal Liver Metastases?

Hepatic resection of limited liver metastases offers curative potential, but for patients with small volume and limited liver involvement, nonsurgical treatment with thermal ablation can also be considered. The international, open-label, randomized, noninferiority COLLISION trial compared hepatic resection to thermal ablation in patients with colorectal cancer and limited (≤10), small (≤3 cm), potentially resectable hepatic metastases.

Of 296 patients, 25% had right-sided and 75% had left-sided or rectal primaries, 78% received induction chemotherapy, and 67% had unknown or missing RAS or BRAF mutation status. Limited surgery and limited ablation were permitted in both treatment groups; in the group randomized to surgery, 61% underwent surge…