Biopsy of resectable colorectal liver metastases causes tumour dissemination and adversely affects survival after liver resection.
BACKGROUND
Liver resection is increasingly being performed for metastatic colorectal cancer. This study assessed the need for preoperative biopsy of suspected metastases and whether biopsy has any effect on long-term survival.


METHODS
Prospectively collected data on patients who underwent liver resection for colorectal metastases between 1986 and 2003 were reviewed retrospectively. The endpoints of morbidity, operative mortality and long-term survival were compared between patients who had biopsy before referral (group 1) and those who did not (group 2).


RESULTS
Patient demographics and disease distribution were similar for 90 patients in group 1 and 508 in group 2. Seventeen patients (19 per cent) who had undergone biopsy either at the time of colorectal resection or radiologically had evidence of needle-track deposits. Operative mortality and morbidity rates in the two groups were similar. The 4-year survival rate after liver resection was 32.5 (s.e. 5.5) per cent in group 1, compared with 46.7 (2.8) per cent in group 2 (P = 0.008).


CONCLUSIONS
Needle-track deposits are common after biopsy of suspected colorectal liver metastases. Biopsy of metastases confers poorer long-term survival on patients after liver resection and cannot be justified in patients with potentially resectable disease.
Department of Hepatobiliary Surgery, North Hampshire Hospital, Aldermaston Road, Basingstoke RG24 9NA, UK.
O M
OM
Jones
M
M
Rees
T G
TG
John
S
S
Bygrave
G
G
Plant
D001707:Biopsy, Needle / Q000009:adverse effects; D015179:Colorectal Neoplasms; D018572:Disease-Free Survival; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis