Thermal ablation versus hepatectomy for solitary colorectal liver metastases up to 5 cm: a multicenter target trial emulation on safety, efficacy, and cost-effectiveness - PubMed
4 hours ago
- #hepatectomy
- #colorectal liver metastases
- #thermal ablation
- Thermal ablation (TA) and hepatectomy (HT) were compared for treating solitary colorectal liver metastases (SCLM) ≤ 5 cm.
- The study involved 1,334 patients from 21 Chinese hospitals, with 437 matched pairs after propensity score matching.
- Primary endpoints were progression-free survival (PFS) and overall survival (OS), with no significant differences found between TA and HT.
- Median PFS was 1.81 years for TA vs 1.95 years for HT (HR 0.94, P = 0.41).
- Median OS was 7.22 years for TA vs 8.09 years for HT (HR 0.89, P = 0.30).
- Five-year PFS and OS rates were comparable between TA and HT groups.
- TA showed fewer severe complications (2.1% vs 5.0%), shorter hospital stays (3 vs 10 days), and lower costs ($4,820 vs $10,239).
- Subgroup analyses confirmed TA's comparable efficacy to HT across various predefined criteria.
- TA is a viable first-line alternative to HT for SCLM ≤ 5 cm, offering similar oncologic outcomes with better safety and cost-effectiveness.