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Table 2 General ‘resectability’ and ‘ablatability’ criteria

From: Colorectal liver metastases: surgery versus thermal ablation (COLLISION) – a phase III single-blind prospective randomized controlled trial

General ‘resectability criteria’ General ‘ablatability criteria’
No size limit Maximum CRLM size ≤3 cm
Aiming at negative (R0) margins Aiming at a tumour free margin of > 10 mm
Leave sufficient FLR (> 20% normal functioning liver parenchyma; > 30% post-chemotherapy) Leave sufficient FLR (> 20% normal functioning liver parenchyma; > 30% post-chemotherapy)
Portal vein embolization of the (most) affected liver lobe may be considered for patients with insufficient FLR To preserve the major bile ducts (common, right and left hepatic duct) a minimum distance (lesion to major bile duct) of 15 mm is required
At least one of three hepatic veins should be preserved and both the portal venous and hepatic arterial blood flow in the future liver remnant should be remain unharmed Radical ablation(s) with or without surgical resections for additional unablatable lesions
Approachable surgical field, without extensive scar formation, major surgical adhesions and/or intestinal herniations (risk of major morbidity estimated > 20%; risk of mortality estimated > 5%) To avoid collateral damage to the intestines a minimum distance to the stomach, small bowel and colon of 15 mm should be pursued in open procedures and respected in percutaneous procedures; Pneumo- or hydrodissections to shift bowels are allowed
Maximum total number of CRLM 10 Maximum total number of CRLM 10