title: Echogenicity of liver metastases is an independent prognostic factor after potentially curative treatment.
abstract: OBJECTIVE
  Intraoperative echogenic appearance of liver metastases from colorectal cancer is a prognostic factor of outcome after curative treatment.
  
  
  METHODS
  Retrospective analysis of prospectively collected data.
  
  
  METHODS
  Department of Surgery at a university hospital.
  
  
  METHODS
  One hundred forty-three consecutive patients with hepatic metastases from colorectal cancer who underwent liver resection with curative intent between 1992 and 1998.
  
  
  METHODS
  Curative treatment was achieved by liver resection alone, liver resection plus edge cryotherapy, or liver resection plus cryotherapy to lesions not amenable to further resection. In patients with more than 2 lesions, a hepatic artery catheter was placed for regional chemotherapy.
  
  
  METHODS
  The echogenic appearance of the liver metastases was assessed by intraoperative ultrasound by a single person throughout the study using a 5-MHz ultrasound probe. The findings were prospectively entered into the database.
  
  
  RESULTS
  Fifty-four percent of patients had hyperechoic metastases. This group had significantly longer overall (log rank, P<.001) and recurrence-free survival (log rank, P =.004) compared with patients who had hypoechoic metastases (36%). A significantly higher percentage of mucin-secreting tumors were found in the hypoechoic patient group (chi(2), P =.001). Dukes stage of the primary tumor (P =.02), echogenicity of the liver secondaries (P =.04), and diameter of the largest resected metastasis (P =.01) were independent prognostic factors for recurrence-free survival in the Cox regression model.
  
  
  CONCLUSIONS
  These results support the hypothesis that echogenicity of liver metastases from colorectal cancer is an independent prognostic factor of outcome after curative resection.
authors.affiliation: UNSW, Department of Surgery, St George Hospital, Pitney Clinical Science Building, Level 3, Kogarah, Sydney, NSW 2217, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Gruenberger
authors.forename: J L
authors.initials: JL
authors.lastname: Jourdan
authors.forename: J
authors.initials: J
authors.lastname: Zhao
authors.forename: J
authors.initials: J
authors.lastname: King
authors.forename: D L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology; D017679:Cryotherapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014463:Ultrasonography