Colorectal Liver Metastases. Aspects on Diagnosis and Surgical Treatment
Summary, in English
Five-year survival rate in 53 patients undergoing intensive follow-up (FU group) after colorectal resection and in 54 patients with no follow-up was 75 and 67 %, respectively, (p>0.05). CEA was the most sensitive indicator of recurrence. Two patients in the FU group were cured from tumour recurrences.
The ability of fine-needle aspiration cytology (FNAC) to correctly classify a liver lesion as benign or malignant was 89 %, but the predictive value when FNAC showed no malignancy was only 27 %. The major complication to FNAC was implantation metastases which occurred in 3 %.
Intraoperative ultrasonography (IOUS) provided new information in 38 % of 91 instances of planned liver resection when compared to preoperative CT and surgical assessment, and lead to changed surgical strategy in 13 %. IOUS predicted resectability in 97% of the operations.
Five-year survival after liver resection for colorectal metastases in 68 patients operated 1971-84 and 43 patients operated 1985-1995 was 19 and 35 %, respectively (p=0.03) (25 % for all patients). Extrahepatic metastases, large number of blood transfusions and no free resection margin were associated with poor outcome. Five-year survival after hepatic re-resection was 29 %.
Median survival in 57 patients with colorectal liver metastases treated with dearterialization was 1.1 years and 5-year survival was 0 %. There was no significant difference in survival between patients treated with temporary and repeated intermittent dearterialization.
- carcinoembryonic antigen
- fine-needle aspiration cytology
- intraoperative ultrasonography
- computed tomography
- liver resection
- Colorectal cancer
- liver metastases
- [unknown] [unknown]
- ISRN: LUMEDW/MESL--1102--SE
26 April 1999
Lecture room 3, Central Building, Lund University Hospital
- Odd Soreide (Professor)