Hepatectomy is Superior to Thermal Ablation for Patients with a Solitary Colorectal Liver Metastasis

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 502 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