Jennie Engstrand

NEW COMET: A randomized trial of thermal ablation and surgical resection of colorectal liver metastases<br/><br/>NoResearch stay abroadA new era in the treatment of liver metastases: the NEW COMET study. The study is trying to find out whether thermal ablation can replace surgical resection of liver metastases from bowel cancer.Colorectal cancer, known as colorectal cancer, is one of the most common cancers in the world. Many patients with this disease experience the cancer spreading to the liver, which can make treatment more challenging. For a long time, surgical removal of the metastases has been considered the best treatment, but in recent years an alternative method, thermal ablation, has become more popular. The question is whether this method can give as good results as surgery. This is what the NEW COMET study is trying to find out.<br/><br/>Background<br/><br/>Thermal ablation is a minimally invasive method that uses heat to destroy cancer cells. This can be done either by radiofrequency ablation (RFA) or microwave ablation (MWA). The advantage of this method is that the procedure can often be done through the skin with a needle, which results in less pain, faster recovery and shorter hospital stays compared to traditional surgery. However, there is a lack of solid scientific evidence that ablation is as effective as surgery.<br/><br/>Main objectives<br/><br/>NEW COMET is a randomized, controlled trial investigating whether thermal ablation is equivalent to surgical removal of liver metastases. The main objective is to compare how many patients experience a recurrence of cancer in the area where the metastasis was treated, within one year after treatment.<br/><br/>Secondary objectives<br/>- Patients' quality of life after treatment<br/>- Cost-effectiveness, that is, which method gives the best results in relation to costs.<br/>- Complications and postoperative pain.<br/>- Overall survival and disease-free survival after treatment.<br/>- Hemodynamic reactions<br/><br/>What makes this study unique?<br/><br/>A major challenge in previous studies of thermal ablation has been what is called selection bias. This means that patients who have received ablation have often been in worse shape or had more severe disease than those who have had surgery. This makes it difficult to compare the results fairly. NEW COMET solves this by using a randomized, double-blind design. This means that the patients are randomly assigned to either surgery or ablation, and neither the patients nor those treating them know which treatment they have received until after one month. <br/><br/>Who participated in the study?<br/><br/>The study has now included 185 out of a total of 230 patients with liver metastases that can be removed either by surgery or ablation. Both treatments must be able to provide radical (complete) removal of the metastases, and the patients must meet strict inclusion criteria. The study is being conducted at several large hospitals in Europe, including Oslo University Hospital, Karolinska (Stockholm), Sahlgrenska (Gothenburg) and the University Hospital of Northern Norway.<br/><br/>What happens next?<br/><br/>The patients will be followed up with CT scans and blood tests for 5 years. In addition, information is collected on quality of life, pain, complications and need for new treatment.<br/><br/>Potential consequences<br/><br/>If the study shows that thermal ablation is equivalent to surgery, it will mean that more patients can receive a less stressful treatment with a shorter recovery time. It will also save the health care system costs associated with longer hospital stays and more complicated procedures.<br/><br/>At the same time, the study will contribute to a better understanding of how to ensure that the ablation is complete, thus minimizing the risk of relapse. If ablation turns out to have worse results than surgery, the study will provide valuable knowledge about which patient groups should avoid this treatment method.<br/>