COLLISION Trial - Colorectal Liver Metastases: Surgery vs Thermal Ablation

The primary objective is to prove non-inferiority of thermal ablation compared to hepatic resection in patients with at least one resectable and ablatable colorectal liver metastases (≤3cm) and no extrahepatic disease.

Sex

All

Minimum age

18 Years

Most important inclusion criteria:

* At least one CRLM size ≤ 3 cm eligible for both surgical resection and thermal ablation (target lesions);
* Additional unresectable CRLM should be ≤ 3 cm and ablatable (unresectable lesions);
* Additional unablatable CRLM should be resectable (unablatable lesions);
* Maximum number of CRLM 10;
* Resectability and ablatability should be re-confirmed intra-operatively by US plus full exploration for hepatic, peritoneal and regional lymph node metastases;
* ASA 1-3.

Most important exclusion criteria:

* No target lesions suitable for both resection and ablation;
* Radical treatment unfeasible or unsafe (e.g. insufficient FLR);
* The presence of extrahepatic nodal or non-nodal metastases;
* Immunotherapy or chemotherapy ≤ 6 weeks prior to the procedure;
* Any surgical resection or focal ablative liver therapy for CRLM prior to inclusion

• DERIVEDvan der Lei S, Puijk RS, Dijkstra M, Schulz HH, Vos DJW, De Vries JJJ, Scheffer HJ, Lissenberg-Witte BI, Aldrighetti L, Arntz M, Barentsz MW, Besselink MG, Bracke B, Bruijnen RCG, Buffart TE, Burgmans MC, Chapelle T, Coolsen MME, de Boer SW, de Cobelli F, de Jong K, de Wilt JHW, Diederik AL, Dooper AMC, Draaisma WA, Eker HH, Erdmann JI, Futterer JJ, Geboers B, Groot GMC, Hagendoorn J, Hartgrink HH, Horsthuis K, Hurks R, Jenniskens SFM, Kater M, Kazemier G, Kist JW, Klaase JM, Knapen RRMM, Kruimer JWH, Lamers ABGN, Leclercq WKG, Liefers GJ, Manusama ER, Meier MAJ, Melenhorst MCAM, Mieog JSD, Molenaar QI, Nielsen K, Nijkamp MW, Nieuwenhuijs VB, Nota IMGC, Op de Beeck B, Overduin CG, Patijn GA, Potters FH, Ratti F, Rietema FJ, Ruiter SJS, Schouten EAC, Schreurs WH, Serafino G, Sietses C, Slooter GD, Smits MLJ, Soykan EA, Spaargaren GJ, Stommel MWJ, Timmer FEF, van Baardewijk LJ, van Dam RM, van Delden OM, van den Bemd BAT, van den Bergh JE, van den Boezem PB, van der Leij C, van der Meer RW, van der Meijs BBM, van der Ploeg APT, van der Reijden JJ, van Duijvendijk P, van Erkel AR, van Geel AM, Van Heek NT, van Manen CJ, van Rijswijk CSP, van Waesberghe JHTM, Versteeg KS, Vink T, Zijlstra IAJ, Zonderhuis BM, Swijnenburg RJ, van den Tol MP, Meijerink MR. Thermal ablation versus surgical resection of small-size colorectal liver metastases (COLLISION): an international, randomised, controlled, phase 3 non-inferiority trial. Lancet Oncol. 2025 Feb;26(2):187-199. doi: 10.1016/S1470-2045(24)00660-0. Epub 2025 Jan 20. PMID 39848272
• DERIVEDPuijk RS, Ruarus AH, Vroomen LGPH, van Tilborg AAJM, Scheffer HJ, Nielsen K, de Jong MC, de Vries JJJ, Zonderhuis BM, Eker HH, Kazemier G, Verheul H, van der Meijs BB, van Dam L, Sorgedrager N, Coupe VMH, van den Tol PMP, Meijerink MR; COLLISION Trial Group. Colorectal liver metastases: surgery versus thermal ablation (COLLISION) - a phase III single-blind prospective randomized controlled trial. BMC Cancer. 2018 Aug 15;18(1):821. doi: 10.1186/s12885-018-4716-8. PMID 30111304