Hepatectomy is superior to thermal ablation for patients with a solitary colorectal liver metastasis.
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.
Schiffman
Suzanne Claire
SC
Division of Surgical Oncology, Department of Surgery, University of Louisville, Norton Healthcare Pavilion, 315 East Broadway, Louisville, KY 40202, USA. scschi01@louisville.edu
Bower
Matthew
M
Brown
Russell E
RE
Martin
Robert C G
RC
McMasters
Kelly M
KM
Scoggins
Charles R
CR
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