title: Prognostic value of different CT measurements in early therapy response evaluation in patients with metastatic colorectal cancer.
abstract: OBJECTIVE
  Patients with advanced stage colorectal carcinoma (CRC) display hepatic metastases on initial staging in up to 20% of cases. The effectiveness of chemotherapy is generally evaluated by computed tomography (CT) imaging using standardized criteria (RECIST). However, RECIST is not always optimal, and other criteria have been shown to correlate with pathologic response and overall survival. The aim of this study was to evaluate the prognostic value of different CT measurement for response assessment after initiation of chemotherapy in patients with synchronous colorectal cancer liver metastases.
  
  
  METHODS
  Fifty-five patients with CRC and synchronous hepatic metastases were evaluated retrospectively at 2 academic centers. Different size, volume, ratio and attenuation parameters were determined at baseline and after 3 cycles of chemotherapy. The prognostic value of baseline measurements and of the change between baseline and second measurements was analyzed using Kaplan-Meier estimates.
  
  
  RESULTS
  Median time to progression was 279 days, median overall survival was 704 days. In this selective patient population, neither a significant prognostic value of initial baseline CT parameters nor a prognostic value of the change between the first and the second CT measurements was found.
  
  
  CONCLUSIONS
  Initial morphological response assessment using different CT measurements has no prognostic value concerning time to progression or overall survival in patients with synchronous colorectal liver metastases.
authors: Department of Radiology and Nuclear Medicine, Lucerne Cantonal Hospital, Switzerland. martin.huellner@usz.ch
authors: M W
authors: MW
authors: Huellner
authors: T P
authors: TP
authors: Hennedige
authors: R
authors: R
authors: Winterhalder
authors: T
authors: T
authors: Zander
authors: S K
authors: SK
authors: Venkatesh
authors: W P
authors: WP
authors: Yong
authors: R A
authors: RA
authors: Soo
authors: B
authors: B
authors: Seifert
authors: T C
authors: TC
authors: Treumann
authors: K
authors: K
authors: Strobel
authors: P
authors: P
authors: Veit-Haibach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D055502:Secondary Prevention; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome