Role of Percutaneous Thermal Ablation in the Management of Resectable Colorectal Liver Metastases in 2026?
Seance of wednesday 29 april 2026 (Journée de cancérologie "Traitement des métastases hépatiques des Cancers Colo-rectaux en 2026")
DOI number : 10.26299/z2wt-v388/emem.2026.18.04
Abstract
Objectives: To evaluate the role of percutaneous thermal ablation in the management of resectable colorectal liver metastases (CRLM) in 2026.
Methods: A review of recent clinical evidence, focusing on the COLLISION Phase III randomized controlled trial comparing thermal ablation to surgical resection for small lesions (≤ 3 cm).
Results: Thermal ablation demonstrates non-inferiority regarding overall survival compared to surgical resection. The percutaneous approach shows a superior safety profile, with a significant reduction in major complications and shorter hospital stays. Local tumor control is optimized by achieving a minimal ablative margin of > 5 mm, supported by the integration of quantitative assessment software and advanced imaging guidance.
Conclusion: By 2026, thermal ablation is a standard of care for small CRLM, providing equivalent oncological outcomes to surgery with significantly improved safety.
Methods: A review of recent clinical evidence, focusing on the COLLISION Phase III randomized controlled trial comparing thermal ablation to surgical resection for small lesions (≤ 3 cm).
Results: Thermal ablation demonstrates non-inferiority regarding overall survival compared to surgical resection. The percutaneous approach shows a superior safety profile, with a significant reduction in major complications and shorter hospital stays. Local tumor control is optimized by achieving a minimal ablative margin of > 5 mm, supported by the integration of quantitative assessment software and advanced imaging guidance.
Conclusion: By 2026, thermal ablation is a standard of care for small CRLM, providing equivalent oncological outcomes to surgery with significantly improved safety.