Related Experiment Video
Updated: Apr 1, 2026
Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
Published on: March 3, 2023
Upfront Thermal Ablation versus Neoadjuvant Chemotherapy Followed by Ablation for Oligometastatic Colorectal Liver
Xiaoning Yue1, Yaqing Kong1, Xiaoyu Huang1
1Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Purpose:
To compare survival outcomes of upfront ablation followed by adjuvant chemotherapy (Ablation first) versus neoadjuvant chemotherapy (NAC) combined with ablation (NAC + Ablation) in patients with oligometastatic colorectal liver metastases (CRLM).
Materials And Methods:
This retrospective study included patients with oligometastatic CRLM (≤ 5 metastases, diameter < 5 cm) treated with thermal ablation (2014-2022). Patients were grouped as Ablation first or NAC + Ablation. Propensity score matching was performed. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), early recurrence rate, and safety.
Results:
After matching, 70 patients per group were analyzed. Median PFS was longer in the Ablation first group than in the NAC + Ablation group (15 vs. 9.5 months; HR 1.51, 95% CI 1.01-2.25; P = 0.047), with lower early recurrence (14.3% vs. 34.3%; P = 0.006). Multivariable analysis confirmed that NAC + Ablation was an independent risk factor for worse PFS (HR 3.30, 95% CI 1.42-7.65; P = 0.006). However, there was no significant difference in OS between the two groups (HR 1.18, 95% CI 0.68-2.06; P = 0.551). No significant differences were observed in ablation complications or chemotherapy-induced adverse events between the groups.
Conclusions:
For patients with ablatable oligometastatic CRLM, upfront ablation was associated with superior PFS and lower early recurrence compared with NAC + Ablation, without compromising procedural safety.
