Outcomes of Combined Hepatectomy and Intraoperative Ablation for Multiple Colorectal Liver Metastases: A Single-Center Retrospective Study
- 1Meiwa Hospital, Nishinomiya 663-8186, Japan
Abstract
Introduction: Radical hepatectomy is the standard curative treatment for colorectal liver metastases (CRLMs). However, extensive resection may be contraindicated in patients with insufficient liver reserve or anatomically complex disease. Although ablation therapy is generally not recommended as a primary curative modality in current guidelines, intraoperative ablation may facilitate parenchymal-sparing, curative-intent treatment in selected high-risk patients. Methods: This retrospective cohort study included 118 patients who underwent curative-intent hepatectomy for multiple CRLM. Patients were categorized into hepatectomy-only (Hx) and hepatectomy plus intraoperative ablation (Hx + Abl) groups, and propensity score matching (PSM) generated 29 balanced pairs. Overall survival (OS) and hepatic progression-free survival (HPFS) were compared using a log-rank test. Cox regression identified predictors of OS, and receiver operating characteristic (ROC) analysis evaluated tumor size associated with local recurrence after ablation. Results: Before PSM, the HX + Abl group showed higher tumor burden and Beppu scores, and demonstrated inferior OS and HPFS. After PSM, oncological outcomes were comparable. Perioperative outcomes, including major complications and post-hepatectomy liver failure (PHLF), were similar. Preoperative chemotherapy was an independent predictor of OS. Among 99 ablated tumors, local recurrence occurred in 12 lesions, and ROC analysis identified tumor size ≤ 15mm as the optimal cutoff predicting local recurrence. Conclusions: In selected high-risk CRLM patients, hepatectomy with intraoperative ablation had no statistically significant difference in OS and HPFS compared with hepatectomy alone without increasing major complications or PHLF.
Related
- Rethinking Surgical Margins in Colorectal Liver Metastases: Vessel-Skeletonized Parenchymal-Sparing Hepatectomy (VESPAH) and Treatment Continuity
- Association between Intraoperative Blood Loss and Postoperative Outcomes in Colorectal Perforation: A Retrospective Observational Study in Japan.
- The Relationship Between Primary Colorectal Cancer Tumour Characteristics and Patient Outcomes Following Surgery for Oligometastatic Pulmonary Metastases: A Single-Centre Retrospective Study.
- Radioembolization for Colorectal Liver Metastases: Indications and Outcomes
- Inflammatory Markers and Outcomes After Liver Resection for Colorectal Liver Metastases.
BibTeX
@article{aihara2026outcomes,
title = {{Outcomes of Combined Hepatectomy and Intraoperative Ablation for Multiple Colorectal Liver Metastases: A Single-Center Retrospective Study}},
author = {Tsukasa Aihara and Shinichi Ikuta and Takayoshi Nakajima and Shinta Nagano and Toshimitsu Iwasaki and Hidenori Yanagi and Naoki Yamanaka},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18203386},
url = {https://www.mdpi.com/2072-6694/18/20/3386},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Outcomes of Combined Hepatectomy and Intraoperative Ablation for Multiple Colorectal Liver Metastases: A Single-Center Retrospective Study
AU - Tsukasa Aihara
AU - Shinichi Ikuta
AU - Takayoshi Nakajima
AU - Shinta Nagano
AU - Toshimitsu Iwasaki
AU - Hidenori Yanagi
AU - Naoki Yamanaka
PY - 2026
DA - 2026/10/20
JO - Cancers
DO - 10.3390/cancers18203386
UR - https://www.mdpi.com/2072-6694/18/20/3386
AB - Introduction: Radical hepatectomy is the standard curative treatment for colorectal liver metastases (CRLMs). However, extensive resection may be contraindicated in patients with insufficient liver reserve or anatomically complex disease. Although ablation therapy is generally not recommended as a primary curative modality in current guidelines, intraoperative ablation may facilitate parenchymal-sparing, curative-intent treatment in selected high-risk patients. Methods: This retrospective cohort study included 118 patients who underwent curative-intent hepatectomy for multiple CRLM. Patients were categorized into hepatectomy-only (Hx) and hepatectomy plus intraoperative ablation (Hx + Abl) groups, and propensity score matching (PSM) generated 29 balanced pairs. Overall survival (OS) and hepatic progression-free survival (HPFS) were compared using a log-rank test. Cox regression identified predictors of OS, and receiver operating characteristic (ROC) analysis evaluated tumor size associated with local recurrence after ablation. Results: Before PSM, the HX + Abl group showed higher tumor burden and Beppu scores, and demonstrated inferior OS and HPFS. After PSM, oncological outcomes were comparable. Perioperative outcomes, including major complications and post-hepatectomy liver failure (PHLF), were similar. Preoperative chemotherapy was an independent predictor of OS. Among 99 ablated tumors, local recurrence occurred in 12 lesions, and ROC analysis identified tumor size ≤ 15mm as the optimal cutoff predicting local recurrence. Conclusions: In selected high-risk CRLM patients, hepatectomy with intraoperative ablation had no statistically significant difference in OS and HPFS compared with hepatectomy alone without increasing major complications or PHLF.
SN - 2072-6694
ER -