Role of ultrasonography in the detection of resectable recurrence after hepatectomy for colorectal liver metastases.
BACKGROUND
Recurrence develops in most patients after hepatectomy for colorectal liver metastases. Repeat resection is feasible in some of these patients. The aim of this study was to evaluate an ultrasound-based follow-up protocol in the detection of resectable recurrent disease.


METHODS
All patients undergoing hepatectomy for colorectal liver metastases at a single hepatobiliary referral centre in the UK from January 1999 to December 2004 were identified. Variables reviewed included rates of recurrence, mode and timing of detection, rates of repeat hepatectomy and survival.


RESULTS
During the study period 191 patients underwent initial resection of colorectal liver metastases, of whom 109 developed recurrent disease. In total, 21 patients underwent potentially curative intervention, including 16 hepatic resections, four pulmonary resections and one staged pulmonary/hepatic resection. Ten of 72 patients who presented with recurrent disease within 12 months after initial resection were amenable to curative resection, compared with 11 of 37 patients presenting after 12 months. Sonographic surveillance identified all of the potentially resectable recurrent hepatic disease in the series.


CONCLUSIONS
Ultrasonography is effective in the detection of potentially resectable hepatic recurrence after hepatectomy for colorectal liver metastases; however, routine chest imaging is needed.
Mann
C D
CD
Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, University Hospitals of Leicester, Gwendolen Road, Leicester LE5 4PW, UK. chris.mann@doctors.org.uk
Metcalfe
M S
MS
Neal
C P
CP
Rees
Y
Y
Dennison
A R
AR
Berry
D P
DP
D015179:Colorectal Neoplasms; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D010166:Palliative Care; D016019:Survival Analysis; D014463:Ultrasonography