Role of ultrasonography in the detection of resectable recurrence after hepatectomy for colorectal liver metastases

Mann, Christopher D.; Metcalfe, Matthew S.; Neal, Christopher P.; McDermott, Yvonne; Dennison, Ashley R.; Berry, David P.

doi:10.1002/bjs.5855

Cited by 10 publications

(4 citation statements)

References 26 publications

(26 reference statements)

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“…In Europe, abdominal ultrasound has proven an effective imaging modality in the detection of hepatic metastases amenable to surgical resection. 26-28 However, in their 2005 update, the American Society of Clinical Oncology did not find sufficient evidence supporting the recommendation for abdominal ultrasound in post treatment surveillance. 10 Only 16% of patients in our study underwent abdominal ultrasound in the 3-year surveillance period.…”

Section: Discussionmentioning

confidence: 99%

Physician follow-up and observation of guidelines in the post treatment surveillance of colorectal cancer

Vargas

Sheffield

Parmar

et al. 2013

Surgery

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Background Guidelines for post resection surveillance of colorectal cancer recommend a collection of the patient's history and physical examination, testing for carcinoembryonic antigen (CEA), and colonoscopy. No consistent guidelines exist for the use of abdominal computed tomography (CT) and position emission tomography (PET)/PET-CT. The goal of our study was to describe current trends, the impact of oncologic follow-up on guideline adherence, and the patterns of use of nonrecommended tests. Methods We used Texas Cancer Registry—Medicare-linked data (2000-2009) to identify physician visits, CEA testing, colonoscopy, abdominal CT, and PET/PET-CT scans in patients ≥66 years old with stage I-III colorectal cancer who underwent curative resection. Compliance with guidelines was assessed with a composite measure of physician visits, CEA tests, and colonoscopy use from start of surveillance. Results In patients who survived 3 years, the overall compliance with guidelines was 25.1%. In patients seen regularly by a medical oncologist, compliance with guidelines increased to 61.5% compared with 8.8% for those not seen by a medical oncologist regularly (P < .0001). The use of abdominal CTand PET/PET-CT increased from 57.5% and 9.5%, respectively, in 2001 to 65.8% and 24.6% (P <.0001) in 2006. Patients who saw a medical oncologist were more likely to get cross-sectionalimagingthan those whodid not (P <.0001). Conclusion Compliance with current minimum guidelines for post treatment surveillance of colorectal cancer is low and the use of nonrecommended testing has increased over time. Both compliance and use of nonrecommended tests are markedly increased in patients seen by a medical oncologist. The comparative effectiveness of CT and PET/PET-CT in the surveillance of colorectal cancer patients needs further examination.

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Section: Discussionmentioning

confidence: 99%

Physician follow-up and observation of guidelines in the post treatment surveillance of colorectal cancer

Vargas

Sheffield

Parmar

et al. 2013

Surgery

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“…In the early studies, liver US was considered effective in the follow-up after surgical treatment of colorectal cancer metastases as it disclosed all the resectable cancer metastases as it disclosed all the resectable with thoracic X-ray [36]. However, more recent data evidence that transabdominal US has limited sensitivity in the diagnostics of CRC liver metastases: 50-75% [17].…”

Section: Radiologic Imaging Techniques In the Diagnostics Of Liver Mementioning

confidence: 99%

Hepatic Surgery for Colorectal Cancer Metastasis — Possibilities and Prerequisites

Štrumfa¹,

Vasko²,

Vanags³

et al. 2015

Recent Advances in Liver Diseases and Surgery

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Colorectal cancer is among the most frequent malignant tumours. Liver metastases develop in % of patients affected by colorectal carcinoma. Nowadays, surgical treatment can significantly improve the -year survival ranging % of the patients undergoing liver surgery. The operation extent ranges from nonanatomic minor resection to major hepatectomy. Recently, liver transplantation has been performed for metastatic colorectal cancer. Laparoscopic approach and robotic surgery can be used by experienced specialists. The prerequisites for successful surgical treatment include exact radiologic diagnostics to determine the number and size of metastases and their association with anatomic structures individual anatomic peculiarities and remnant liver volume, ranging % in respect to functional liver status. Magnetic resonance imaging is the most sensitive method that has marked advantages in the diagnostics of lesions smaller than cm and metastases on the background of liver steatosis. Computed tomography is an acceptable alternative that benefits from high spatial resolution and optimal reconstructions to evaluate the anatomy. Additional information can be obtained from tumour markers, including traditional, e.g., carcinoembryonic antigen CEA and novel, e.g., microRNAs. To ensure that each colorectal cancer patient receives the best care, the medical society should be well informed about the possibilities in the treatment of liver metastases of colorectal cancer regarding the methods, indications and limits.Keywords: Colorectal cancer, liver metastasis, liver resection, magnetic resonance imaging © 2015 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. . IntroductionColorectal cancer CRC represents one of the leading malignant tumours both by incidence and death rate [ , ]. Metastatic spread to liver occurs in % of patients, and % of CRC patients present with synchronous liver metastases [ , , ]. Although the presence of metastatic disease significantly adversely affects the survival, a wide scope of treatment options exists. To ensure that each colorectal cancer patient receives the best care, the medical society should be well informed about the possibilities in the treatment of liver metastases of colorectal cancer regarding the methods, indications and limits.Surgery is the preferred option for long term survival. The operation extent ranges from major hepatic resection trisegmentectomy, hepatectomy, extended hepatectomy, and hemihepatectomy to parenchyma-sparing minor resection such as segmentectomy or wedge resection [ ]. Laparoscopic approach and robotic surgery can be considered, especially in advanced centres [ , ]. In patients with questionable adequacy of the liver remnant and wide intrahepatic tumour spread, portal vein occlusion, forced liver hypertrophy and staged ...

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“…Trials comparing the sensitivity of ultrasound against CT scan in detecting resectable recurrent disease have shown favorable results for CT scan, but the data lacked statistical significance 28,143,147,148. The CEA level is widely used for following patients after curative colorectal resection, but its value for the detection of resectable hepatic recurrence is nonexistent 143,149. By the time elevated levels of CEA are detected in the follow up, the hepatic recurrence is usually beyond the stage of resection.…”

Section: Follow Upmentioning

confidence: 99%

“…The underlying basis of the recurrence may be related to the presence of undetected or inadvertent dissemination of micrometastases in the liver at the time of surgery. A close look at the course of the recurrent disease reveals that, despite being adequately followed up, only 10%–20% of the patients are enrolled for a repeat resection . It is likely that by the time these recurrences are detected the disease is no longer liver‐confined.…”

Section: Follow Upmentioning

confidence: 99%

Management of hepatic metastasis from colorectal cancers: an update

Sharma

Camcı

Jabbour

2008

J Hepatobiliary Pancreat Surg

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Approximately 50%-60% of patients with colorectal cancers will develop liver lesions in their life span. Despite the potential of surgical resection to provide long-term survival in this subset of patients, only 15%-20% are found to be resectable. The introduction of new neoadjuvant chemotherapeutic agents and the expanding criteria of resection have enhanced the overall 5-year survival from 30% to 60% in the past decade. The use of technical innovations such as staged resection; portal vein embolization, and repeat resection have allowed higher resection rates in patients with bilobar disease. Extrahepatic primary and liver-exclusive recurrent disease no longer represent an absolute contraindication to resection. The role of regional therapy using hepatic arterial infusion is being redefi ned for liver-exclusive unresectable disease. Adjuvant chemotherapy in combination with regional therapies is being looked at from fresh perspectives. Ablative approaches have gained a fi rm role both as an adjunct to surgical resection and in the management of patients who are not surgical candidates. Overall, the management of hepatic metastasis from colorectal cancers requires a multimodal approach.

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Role of ultrasonography in the detection of resectable recurrence after hepatectomy for colorectal liver metastases

Abstract: Ultrasonography is effective in the detection of potentially resectable hepatic recurrence after hepatectomy for colorectal liver metastases; however, routine chest imaging is needed.

Cited by 10 publications

References 26 publications

Physician follow-up and observation of guidelines in the post treatment surveillance of colorectal cancer

Physician follow-up and observation of guidelines in the post treatment surveillance of colorectal cancer

Hepatic Surgery for Colorectal Cancer Metastasis — Possibilities and Prerequisites

Management of hepatic metastasis from colorectal cancers: an update

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