Hepatectomy is superior to thermal ablation for patients with a solitary colorectal liver metastasis

Abstract

Introduction: Hepatic resection is the mainstay of treatment for solitary colorectal liver metastases (mCRC); however, some patients are not ideal candidates. The aim of this study was to compare outcomes for patients with solitary mCRC who underwent resection or ablation.

Methods: A retrospective review of a hepatobiliary database identified patients with solitary mCRC. Patients who were treated with hepatectomy were compared to patients who underwent thermal ablation.

Results: The median follow-up time was 25.9 months. Ninety-four patients (67.1%) underwent resection whereas 46 patients (32.8%) underwent ablation. Of the resected patients, most (60%) required a major hepatectomy. Tumor ablation was a significant predictor of overall survival (p = 0.002, OR 3.75, 95% CI 1.696-8.284). Overall, the median disease-free survival was 55.2 months for patients undergoing resection vs. 42.6 months for ablated patients (p = 0.073). Median overall survival was 112.7 months for patients undergoing resection vs. 50.2 months for patients undergoing ablation (p = 0.005).

Conclusion: Patients with solitary hepatic colorectal cancer metastases should be considered for hepatic resection as this provides superior survival when compared to thermal ablation.