Solidifying local ablation in the treatment of small-size colorectal liver metastasis

Mené sur 300 patients présentant des métastases hépatiques de petite taille ayant pour origine un cancer colorectal (durée médiane de suivi : 28,9 mois), cet essai randomisé international de phase III évalue la non-infériorité, du point de vue de la survie globale, d'une thermoablation par rapport à une résection des métastases

Résumé en anglais

Approximately 50% of patients with colorectal cancer will develop liver metastasis which remains a major cause of colorectal cancer-related death.1 Resection is considered as one of the cornerstones of therapy in liver-limited metastatic colorectal cancer, generally eliciting 5-year survival rates of 20–50%.2 Technical resectablity is dependent on factors such as locations, number, and size of the tumours. Considering high recurrence rates, potentially extensive resections such as two-stage hepatectomies, where small-size liver remnants often represent an impediment towards repeat resections, need to be weighed against the need for future interventions. Local ablation techniques are established approaches to treat liver lesions and are recommended for patients with oligometastatic disease under current European Society for Medical Oncology guidelines.3 In clinical practice, leading centres around the world have employed an approach of repeat interventions, combining resection with ablation and systemic therapy to prolong survival. To date, the interchangeability of these treatments has not been sufficiently clarified.