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Updated: Jan 19, 2026
Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
Published on: March 3, 2023
Tailoring ablation strategies for colorectal liver metastases based upon rat sarcoma viral oncogene mutation status
Marco Calandri1, Bruno C Odisio2
1Radiology Unit, Department of Oncology, A.O.U. San Luigi Gonzaga di Orbassano, University of Turin, Turin, Italy.
Abstract:
Rat sarcoma viral oncogene (RAS) is one of the most well-known tumor genes implicated in the oncological and surgical management of patients with colorectal liver metastases (CLM). More recently, RAS mutational status has also emerged as a relevant factor affecting the oncological outcomes of CLM treated with ablation procedures, a well-established local therapy modality routinely utilized in the oligometastatic disease (OMD) setting. Available evidence suggests that RAS mutation is a prognosticator of shorter local tumor progression free survival (LTPFS) following liver ablation, and that mutant RAS patients with CLM treated with ablation should have wider minimal ablation margins. In this review, we aim to discuss the current literature on the influence of RAS mutational status on ablation outcomes, as well to provide a perspective on the future research on the impact of tumor molecular biology on liver ablation procedures and the potential synergies between local and systemic therapies.
Insights
RAS mutation status impacts outcomes for colorectal liver metastases treated with ablation. Mutant RAS patients may require wider ablation margins for better local tumor progression-free survival.
Area of Science:
- Oncology
- Molecular Biology
- Interventional Radiology
Background:
- Rat sarcoma viral oncogene (RAS) mutations are key in colorectal liver metastases (CLM).
- RAS mutational status influences outcomes for CLM treated with ablation, a local therapy for oligometastatic disease (OMD).
Purpose of the Study:
- To review the literature on RAS mutational status and liver ablation outcomes in CLM.
- To discuss future research on molecular biology's impact on liver ablation and combined therapies.
Main Methods:
- Literature review of studies investigating RAS mutational status in CLM treated with liver ablation.
Main Results:
- RAS mutation is a prognosticator of shorter local tumor progression-free survival (LTPFS) after liver ablation.
- Wider minimal ablation margins may be necessary for CLM patients with mutant RAS.
Conclusions:
- RAS mutational status is a critical factor in predicting CLM response to liver ablation.
- Personalized ablation strategies based on RAS status and exploration of combined local-systemic therapies are warranted.
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