Efficacy of follow-up after surgical treatment of colorectal liver metastases

Abstract

Purpose There is an increasing tendency for an aggressive approach to colorectal liver metastases (CLM), even as second stage procedures after initial hepatic resection. This study assesses the efficacy of intensive follow-up after resection of CLM. Patients and methods Hundred and three patients, operated on for CLM, were followed for disease recurrence. Outcome measures were time and imaging modality that revealed recurrence, performed treatment for recurrence, and overall survival. Results After hepatic resection, 1- and 3-year overall survival (OS) rates were 91% and 50%, the disease-free survival rates 63% and 45%. Seventy-four patients developed recurrent disease during follow-up. Resection of recurrence was performed in 25 patients. OS of this group was 51 months. Patients with recurrence treated by chemotherapy had an OS of 34 months. In case of recurrence, 70% was observed within 12 months, 92% within 24 months. CT appeared to be far a very useful surveillance modality, directing surgical treatment in 19 asymptomatic patients. Discussion Follow-up of patients after surgical treatment of CLM proves worthwhile, resulting in meaningful re-operations in a quarter of all patients that underwent hepatic resection for CLM.