Scholarlink

Purpose <p>To compare survival outcomes of upfront ablation followed by adjuvant chemotherapy (Ablation first) versus neoadjuvant chemotherapy (NAC) combined with&#xa0;ablation (NAC + Ablation) in patients with oligometastatic colorectal liver metastases (CRLM).</p> Materials and Methods <p>This retrospective study included patients with oligometastatic CRLM (≤ 5 metastases, diameter &lt; 5&#xa0;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.</p> Results <p>After 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&#xa0;months; HR 1.51, 95% CI 1.01–2.25; <i>P</i> = 0.047), with lower early recurrence (14.3% vs. 34.3%; <i>P</i> = 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; <i>P</i> = 0.006). However, there was no significant difference in OS between the two groups (HR 1.18, 95% CI 0.68–2.06; <i>P</i> = 0.551). No significant differences were observed in ablation complications or chemotherapy-induced adverse events between the groups.</p> Conclusions <p>For patients with ablatable oligometastatic CRLM, upfront ablation was associated with superior PFS and lower early recurrence compared with NAC + Ablation, without compromising procedural safety.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Upfront Thermal Ablation versus Neoadjuvant Chemotherapy Followed by Ablation for Oligometastatic Colorectal Liver Metastases: A Propensity Score Matching Analysis

  • 期刊论文

  • 发表日期：

    2026年3月31日

查看全文
  • Xiaoning Yue,
  • Yaqing Kong,
  • Xiaoyu Huang,
  • Xiaojing Cao,
  • Fan Tang,
  • Xiang Zhou

摘要

Purpose

To 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 Methods

This 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.

Results

After 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.

Conclusions

For patients with ablatable oligometastatic CRLM, upfront ablation was associated with superior PFS and lower early recurrence compared with NAC + Ablation, without compromising procedural safety.

Graphical Abstract