Echogenicity of liver metastases from colorectal carcinoma is an independent prognostic factor in patients treated with regional chemotherapy.
BACKGROUND
Echogenicity of liver metastases was found to be a predictive biologic factor influencing long-term outcome after curative liver resection. The current analysis focuses on the influence of echogenicity on survival in patients treated with intraarterial chemotherapy for unresectable colorectal carcinoma liver metastases.


METHODS
A retrospective analysis of prospectively collected data at the Department of Surgery at the University of New South Wales-affiliated St. George Hospital was performed. Two hundred twelve consecutive patients with unresectable hepatic metastases from colorectal carcinoma treated between May 1992 and September 2000 were analyzed. Echogenicity of metastases was measured intraoperatively using a 5 MHz probe. Overall survival difference was compared between hyper- and hypoechoic metastases on an intention-to-treat basis.


RESULTS
At a median followup of 15.1 months, 47 patients (22%) were alive and 165 (78%) had died. A significant survival benefit was observed in patients having hyperechoic lesions (median survival 16.2 months, 95% confidence interval [CI] 13.9-18.5) compared to hypoechoic lesions (median survival 11.6 months, 95% CI 8-15.2), P < 0.01. Other prognostic factors were differentiation of the primary tumor (P < 0.02), percentage hepatic replacement (P < 0.05) and carcinoembryonic antigen decrease (P < 0.03). Echogenicity was identified as an independent prognostic factor in multivariate analysis (P < 0.009).


CONCLUSIONS
Echogenicity is an important prognostic survival parameter.
Gruenberger
Thomas
T
Department of Surgery, University of New South Wales, St. George Hospital, Kogarah, Australia.
Zhao
Jing
J
King
Julie
J
Chung
TengTeng
T
Clingan
Phil R
PR
Morris
David L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005467:Floxuridine / Q000627:therapeutic use; D005472:Fluorouracil / Q000627:therapeutic use; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014463:Ultrasonography
D000970:Antineoplastic Agents; D005467:Floxuridine; D005472:Fluorouracil