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The only randomised trial to show that burning out liver metastases, rather than just giving chemotherapy, lets more people survive eight years.
CLOCC randomised 119 patients with unresectable colorectal liver metastases to systemic treatment plus radiofrequency ablation (with resection where possible) or to systemic treatment alone. The trial closed early for slow accrual and was reported as a randomised phase 2 study. At a median follow-up of 9.7 years, 39 of 60 patients in the combined modality group had died against 53 of 59 in the systemic group; overall survival favoured local treatment (hazard ratio 0.58, 95% CI 0.38 to 0.88, p=0.01). Eight-year overall survival was 35.9 against 8.9 percent, and median overall survival 45.6 against 40.5 months. Small and underpowered, CLOCC is nonetheless the only randomised evidence that ablation of liver metastases lengthens life, and it underpins the aggressive local treatment of oligometastatic colorectal cancer.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Hepatectomy (liver resection), Oligometastatic disease, EORTC, Oxaliplatin.
Shares Hepatectomy (liver resection), Oligometastatic disease, Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares Radiofrequency ablation (RFA), Microwave and radiofrequency ablation systems, Thermal ablation (RFA, microwave, cryo).
Shares Radiofrequency ablation (RFA), Thermal ablation (RFA, microwave, cryo), Colorectal cancer.
Shares Hepatectomy (liver resection), Oligometastatic disease, FOLFOX (5-FU, leucovorin, oxaliplatin), Bevacizumab.
Shares Radiofrequency ablation (RFA), Hepatectomy (liver resection), Thermal ablation (RFA, microwave, cryo), Colorectal cancer.
Shares Oxaliplatin, Bevacizumab, Colorectal cancer.
Shares FOLFOX (5-FU, leucovorin, oxaliplatin), Bevacizumab, Cytotoxic chemotherapy, Colorectal cancer.