Synchronous and metachronous liver metastases in patients with colorectal cancer-towards a clinically relevant definition.
World J Surg Oncol
; 17(1): 228, 2019 Dec 26.
Article
em En
| MEDLINE
| ID: mdl-31878952
ABSTRACT
BACKGROUND:
Approximately 25% of patients with colorectal cancer (CRC) will have liver metastases classified as synchronous or metachronous. There is no consensus on the defining time point for synchronous/metachronous, and the prognostic implications thereof remain unclear. The aim of the study was to assess the prognostic value of differential detection at various defining time points in a population-based patient cohort and conduct a literature review of the topic.METHODS:
All patients diagnosed with CRC in the counties of Stockholm and Gotland, Sweden, during 2008 were included in the study and followed for 5 years or until death to identify patients diagnosed with liver metastases. Patients with liver metastases were followed from time of diagnosis of liver metastases for at least 5 years or until death. Different time points defining synchronous/metachronous detection, as reported in the literature and identified in a literature search of databases (PubMed, Embase, Cochrane library), were applied to the cohort, and overall survival was calculated using Kaplan-Meier curves and compared with log-rank test. The influence of synchronously or metachronously detected liver metastases on disease-free and overall survival as reported in articles forthcoming from the literature search was also assessed.RESULTS:
Liver metastases were diagnosed in 272/1026 patients with CRC (26.5%). No statistically significant difference in overall survival for synchronous vs. metachronous detection at any of the defining time points (CRC diagnosis/surgery and 3, 6 and 12 months post-diagnosis/surgery) was demonstrated for operated or non-operated patients. In the literature search, 41 publications met the inclusion criteria. No clear pattern emerged regarding the prognostic significance of synchronous vs. metachronous detection.CONCLUSION:
Synchronous vs. metachronous detection of CRC liver metastases lacks prognostic value. Using primary tumour diagnosis/operation as standardized cut-off point to define synchronous/metachronous detection is semantically correct. In synchronous detection, it defines a clinically relevant group of patients where individualized multimodality treatment protocols will apply.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Segunda Neoplasia Primária
/
Neoplasias do Colo
/
Neoplasias Hepáticas
/
Neoplasias Primárias Múltiplas
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Systematic_reviews
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
World J Surg Oncol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Suécia