ArticleBMC medicine2026
Thermal ablation versus hepatectomy for solitary colorectal liver metastases up to 5 cm: a multicenter target trial emulation on safety, efficacy, and cost-effectiveness.
Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Thermal ablation versus liver resection for small colorectal liver metastases (≤ 3 cm): a systematic review and meta-analysis of randomized and propensity score-matched studies.Surgical endoscopy · 2026Pooled it
- Thermal Ablation for Colorectal Liver Metastases: Current Evidence and Future Horizons.Diagnostics (Basel, Switzerland) · 2026Review
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNo randomized trials or large-scale observational studies directly compared thermal ablation (TA) and hepatectomy (HT) for solitary colorectal liver metastases (SCLM) ≤ 5 cm with long-term follow-up.
methodsIn this multicenter target trial emulation (2009-2024), 1,334 patients with SCLM ≤ 5 cm from 21 Chinese hospitals were enrolled. Propensity score matching (1:1) balanced baseline characteristics, yielding 437 matched pairs. Primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS), respectively. Complications, hospital stay, and costs were analyzed. Sensitivity analyses were performed to evaluate the robustness of the results.
resultsAfter matching, median PFS was 1.81 years (95% CI 1.60-2.04) for TA vs 1.95 years (1.67-2.34) for HT (HR 0.94, 95% CI 0.82-1.09; P = 0.41). Median OS was 7.22 years (6.43-9.05) for TA vs 8.09 years (6.68-10.58) for HT (HR 0.89, 0.71-1.11; P = 0.30). The Five-year PFS and OS rates were comparable between groups. The PFS rates were 30.05% (95% CI: 25.32%-35.67%) for TA and 32.16% (95% CI: 27.49%-37.63%) for HT, while OS rates were 62.36% (95% CI: 56.24%-69.14%) for TA and 67.79% (95% CI: 62.38%-73.66%) for HT. TA reduced Clavien-Dindo III-IV complications (2.1% vs 5.0%; P = 0.017), hospital stay (median 3 vs 10 days; P < 0.001), and costs (median $4,820 vs $10,239; P < 0.001). Across all predefined subgroups (e.g., tumor size, CRS), treatment with TA resulted in PFS and OS comparable to those achieved with HT.
conclusionsFor SCLM ≤ 5 cm, TA provides comparable oncologic outcomes to HT, alongside superior safety and cost-effectiveness. This supports its role as a first-line therapeutic alternative for selected patients or when surgery is contraindicated.
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