A trial comparing surgery with ablation treatment for people with bowel cancer spread to the liver (LAVA)

Sometimes cells can break away from where the cancer first started and spread to other parts of the body, such as the liver. This is called metastatic or secondary liver cancer. 

When this trial was done, one of of the usual treatments was to remove these areas with an operation. This was standard treatment for advanced bowel cancer if you are under 70 years old and fit enough for an operation. 

Removing liver tumours is major surgery. And doctors aren’t sure of the best treatment for people where having surgery could be risky. For example in:

• older people
• people with other medical conditions such as heart or lung problems
• people who have large areas of cancer in the liver

Researchers thought treatment to kill cancer cells with heat might help. This is called thermal ablation. It was already used to treat advanced bowel cancer in the liver when this trial was done. 

In this trial, doctors wanted to find out for sure which treatment works best for the above groups of people. 

The main aims of the trial were to:

• find out how willing people are to take part
• find out if thermal ablation or surgery works best
• learn more about side effects and how they affect quality of life