Thermal ablation of colorectal liver metastases
Topic Status Complete
Thermal ablation of liver metastases in people with colorectal cancer
Outcome of the appraisal
The evidence supports the routine adoption of thermal ablation as a treatment option to treat colorectal cancer liver metastases in adults who are eligible for surgical resection.
There is evidence that thermal ablation is equivalent to surgical resection for overall survival or any progression-free survival outcomes. There is also evidence of reduced complications and length of stay following treatment with thermal ablation when compared to surgical resection, and hepatic retreatment may be more common in patients treated with thermal ablation.
A cost analysis conducted by HTW found that thermal ablation was expected to be a cost saving treatment option, and this finding was robust to both model input changes and adjustments to key modelling assumptions.
Why was this topic appraised?
On diagnosis of colorectal cancer, up to 30% of people are found to have metastases and a further 30% to 50% go on to develop metastases within five years of diagnosis. The liver is the most common site for metastases.
Resection of colorectal cancer liver metastases offers survival benefits and can be curative. Thermal ablation has been proposed as an alternative to surgical resection in patients with ten or fewer colorectal liver metastases of 3 cm or less in diameter that are considered to be resectable.
This topic was proposed by a consultant clinical oncologist working in the NHS in Wales.
Plain language summary
What are colorectal liver metastases?
Metastases is the term for cancer that spreads to another part of the body. In cancer that starts in the colon or rectum (colorectal), metastases are often found in the liver. These are known as colorectal liver metastases.
How are colorectal liver metastases usually treated?
Treatment is usually surgery to remove part of the liver. If a patient isn’t suitable for surgery, they may be offered thermal ablation.
What is thermal ablation?
Thermal ablation is a treatment where heat is used to destroy the cancer cells. There are 2 types of thermal ablation, radiofrequency ablation and microwave ablation. A radiologist uses either an ultrasound scan or a CT scan to guide a special needle into the cancerous cells. Once it is in the correct place, the needle is heated using electrical energy (radiotherapy ablation) or microwave energy (microwave ablation). The needle heats the cancer cells and destroys them.
What did Health Technology Wales do?
Health Technology Wales looked for evidence about the effects of thermal ablation on colorectal liver metastases in adults. The evidence supports the routine adoption of thermal ablation as a treatment option to treat colorectal cancer liver metastases in adults who are eligible for surgical resection.
Guidance
GUI071 10.2025
Evidence Appraisal Report
EAR071 10.2025
Topic Exploration Report
TER560 11.2024 (superseded by EAR071 10.2025)
Health Technology Wales Partners
