Surveillance and outcome of liver metastasis in patients with colorectal cancer who had undergone curative-intent operation.

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.