Ablation vs Resection of Colorectal Cancer Liver Metastases

Inclusion Criteria: * Histologically verified colorectal cancer * Colorectal liver metastases (proven or suspected) eligible for radical treatment using EITHER resection OR ablation (not a combination), as decided by the liver MDT meeting at the study center * The patient is fit to undergo both resection and ablation of all liver metastases * Size of largest lesion up to and including 30 mm * In case of solitary metastasis, resection plan includes resection of ≤ 2 anatomical segments. * In case of multiple metastases in one continuous resection, resection plan can include ≤ 4 anatomical segments (including hemihepatectomy) * ≤ 5 tumors to be treated in one procedure * Primary tumor either resected (primary first) or with a plan for curative treatment (liver first). Exclusion Criteria: • More than 3 lung metastases where 1 is \>10mm, or 1 lung metastasis \>15 mm (OR: unresectable lung metastases as decided by the lung MDT meeting) * Presence of extrahepatic, extrapulmonary metastases. * Surgical indication for removal of enlarged lymph nodes in the hepatic hilum. (Enlarged lymph nodes without indication of removal are not considered an exclusion criterium) * Tumor closer than 10 mm to right/left main bile duct * Suspected tumor infiltration to adjacent organs * Progression (as of RECIST \[18\]) on 2nd line chemotherapy * Previous inclusion in this trial * Not eligible for workup according to study criteria * Contraindication to contrast enhanced CT scan * Manifest liver ci…