Hong Kong Med J 2008;14:432-6 | Number 6, December 2008
Surveillance and outcome of liver metastasis in patients with colorectal cancer who had undergone curative-intent operation
KC Cheng, YP Yeung, Patrick YY Lau, William CS Meng
Department of Surgery, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong
OBJECTIVE. To assess the outcome of patients diagnosed to have liver metastasis by ultrasonography, following curative-intent resection of colorectal adenocarcinoma.
DESIGN. Prospective study.
SETTING. Regional hospital, Hong Kong.
PATIENTS. A total of 650 patients who underwent curative-intent resection of colorectal adenocarcinoma between January 2000 and December 2006.
MAIN OUTCOME MEASURES. Pattern of liver recurrence, treatment and outcome after recurrence, and overall patient survival.
RESULTS. Of the 650 patients, 553 (85%) were followed up per protocol. Of 104 patients who developed systemic recurrence, 45 (43%) had liver-only metastases. The resection rate for liver metastases was 38% (17/45). The median survival of such patients was significantly longer than those who did not undergo liver metastasectomy (50 vs 26 months, P=0.017).
CONCLUSION. Our ultrasonography-based surveillance protocol was low-cost, simple, and effective in detecting asymptomatic liver metastases, so that curative-intent metastasectomy could be performed. Further prospective studies are required to determine the optimal frequency and imaging mode for surveillance, so as to improve the resectability of liver-only colorectal metastases as well as overall patient survival.
Key words: Colorectal neoplasms; Neoplasm metastasis; Survival analysis
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