title: Hepatectomy is superior to thermal ablation for patients with a solitary colorectal liver metastasis.
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  Patients with solitary hepatic colorectal cancer metastases should be considered for hepatic resection as this provides superior survival when compared to thermal ablation.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, Norton Healthcare Pavilion, 315 East Broadway, Louisville, KY 40202, USA. scschi01@louisville.edu
authors.forename: Suzanne Claire
authors.initials: SC
authors.lastname: Schiffman
authors.forename: Matthew
authors.initials: M
authors.lastname: Bower
authors.forename: Russell E
authors.initials: RE
authors.lastname: Brown
authors.forename: Robert C G
authors.initials: RC
authors.lastname: Martin
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
authors.forename: Charles R
authors.initials: CR
authors.lastname: Scoggins
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies