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Comparative Study
. 2025 Oct;39(10):6514-6524.
doi: 10.1007/s00464-025-12040-5. Epub 2025 Aug 13.

Laparoscopic resection combined with ablation for multiple colorectal liver metastases: a multicentre propensity-matched analysis

Huachuan Song #  1   2   3 , Zhipeng Li #  4 , Shenyu Zhang #  1   2   3 , Xinyu Ling  1   2   3 , Long Chen  1   2   3 , Yongshuai Wang  1   2   3 , Feng Zhang  1   2   3 , Ruipeng Song  1   2   3 , Lianxin Liu  1   2   3 , Fanzheng Meng  1   2   3 , Zehua Wu  4 , Bing Han  5 , Jizhou Wang  6   7   8
Affiliations
Comparative Study

Laparoscopic resection combined with ablation for multiple colorectal liver metastases: a multicentre propensity-matched analysis

Huachuan Song et al. Surg Endosc. 2025 Oct.

Abstract

Background: Laparoscopic resection is the standard treatment for resectable colorectal liver metastases (CRLM). While the safety profile using combined ablation and resection (CARe) to treat CRLM has been documented, its efficacy has not been compared with that of resection alone in the laparoscopic setting. The aim of this study was to compare the short- and long-term outcomes of laparoscopic CARe with those of laparoscopic resection alone for multiple CRLM.

Methods: Patients with multiple CRLM who underwent laparoscopic resection at three medical centres from 2018 to 2023 were included. Perioperative and oncological outcomes were compared between the two groups. Propensity score matching (PSM) was performed.

Results: Of the 218 included patients, 67 (30.7%) underwent laparoscopic CARe, and 151 (69.3%) underwent laparoscopic resection alone. After PSM, 49 matched pairs of patients were included for each group. The postoperative complication rate was similar between the two groups (P = 0.964). The median recurrence-free survival (RFS) (11.8 vs. 12.1 months, P = 0.759) and overall survival (OS) (not reached, P = 0.656) were not significantly different between the two groups. Multivariate analysis revealed that ≥ 4 CRLM [hazard ratio (HR) = 1.86, 95% confidence interval (CI) 1.09-3.15, P = 0.022] and synchronous metastases (HR = 2.00, 95% CI 1.21-3.31, P = 0.007) and was independently associated with RFS, whereas bilobar distribution (HR = 3.20, 95% CI 1.04-9.82, P = 0.042) was independently associated with OS. No statistically significant differences were observed in the timing of recurrence (P = 0.666), the site of recurrence (P = 0.279), or the treatment administered after recurrence (P = 0.641) between the two groups.

Conclusions: Laparoscopic CARe may be considered as a useful treatment strategy for multiple CRLM.

Keywords: Ablation; Colorectal liver metastases; Laparoscopy; Liver resection; Minimally invasive surgery.

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Conflict of interest statement

Declarations. Disclosures: Huachuan Song, Zhipeng Li, Shenyu Zhang, Xinyu Ling, Long Chen, Yongshuai Wang, Feng Zhang, Ruipeng Song, Fanzheng Meng, Lianxin Liu, Zehua Wu, Bing Han, and Jizhou Wang have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Study flow chart. CRLM colorectal liver metastases, CARe combined ablation and resection
Fig. 2
Fig. 2
Recurrence-free survival, overall survival before propensity score matching. A recurrence-free survival (P = 0.003). B overall survival (P = 0.690). CARe combined ablation and resection
Fig. 3
Fig. 3
Recurrence-free survival, overall survival after propensity score matching. A recurrence-free survival (P = 0.759). B overall survival (P = 0.656). CARe combined ablation and resection
See this image and copyright information in PMC

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