COLLISION Trial Seeks to Answer Time-Honored Question: “Thermal Ablation or Surgery for Colorectal Liver Metastases?”

Excerpt

We are honored to highlight the recently started COLLISION trial that will compare thermal ablation to surgical resection for small resectable colorectal liver metastases (CRLM 0–3 cm) [1]. Since colorectal cancer is the third most common malignancy worldwide and the second most common cause of cancer-related deaths in developed countries, this trial encompasses a major medical concern [2]. Although approximately half of all patients develop liver metastases in course of their disease, only 15–20% is considered eligible for curative intent surgical resection. For patients with an impaired general health status, history of extensive abdominal surgery, the presence of lesions with an unfavorable anatomical location or an insufficient future liver remnant to perform partial hepatectomy, thermal ablation nowadays is accepted worldwide to eliminate small unresectable CRLM. The minimal invasive and parenchyma-sparing nature, good and still improving efficacy with the potential to repeat procedures in case of local tumor progression, low costs and short hospital stay of thermal ablation have made it impossible to postulate generally accepted resectability criteria, especially for small and deep-seeded CRLM that require major hepatectomy [3]. …