ArticleCardiovascular and interventional radiology2026
Upfront Thermal Ablation versus Neoadjuvant Chemotherapy Followed by Ablation for Oligometastatic Colorectal Liver Metastases: A Propensity Score Matching Analysis.
Article in Cardiovascular and interventional radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo 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
methodsThis 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.
resultsAfter 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.
conclusionsFor patients with ablatable oligometastatic CRLM, upfront ablation was associated with superior PFS and lower early recurrence compared with NAC + Ablation, without compromising procedural safety.
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