TY - JOUR
T1 - Detection of hepatic metastases in colorectal cancer
T2 - A prospective study of laboratory and imaging methods
AU - Ohlsson, B.
AU - Tranberg, K. G.
AU - Lundstedt, C.
AU - Ekberg, H.
AU - Hederstrom, E.
PY - 1993/1/1
Y1 - 1993/1/1
N2 - Objective: To assess and compare the accuracy of imaging methods (ultrasonography (US), computed tomography (CT), angiography, arterially enhanced CT with computed tomographic arterial portography (CTA)), biochemical analyses, and surgical assessment during the operation, in detecting the presence or absence of hepatic metastases in patients with colorectal cancer. Design: Open study. Setting: University of Lund, Sweden. Subjects: 71 consecutive patients without clinical evidence of liver metastases at the time of the operation for removal of the primary tumour. Interventions: Regular biochemical tests for five to seven years, and CT and US one year after operation in all patients without confirmed metastases. Main outcome measures: Presence or absence of hepatic metastases. Results: Accuracy of surgical assessment, angiography, US, CT and CTA was 90, 77, 80, 82 and 83%, respectively, and corresponding predictive values of a negative test were 87, 75, 77, 80 and 84%. Measurement of bilirubin concentration and hepatic enzyme activities were not helpful, and that of carcinoembryonic antigen had an accuracy of only 70%. Accuracy and predictive values were not improved by combining tests. Conclusion: The accuracy of US, CT or CTA was not good enough to merrit routine use before operations for colorectal cancer. They are potentially valuable for monitoring progress at follow up, but this remains to be confirmed.
AB - Objective: To assess and compare the accuracy of imaging methods (ultrasonography (US), computed tomography (CT), angiography, arterially enhanced CT with computed tomographic arterial portography (CTA)), biochemical analyses, and surgical assessment during the operation, in detecting the presence or absence of hepatic metastases in patients with colorectal cancer. Design: Open study. Setting: University of Lund, Sweden. Subjects: 71 consecutive patients without clinical evidence of liver metastases at the time of the operation for removal of the primary tumour. Interventions: Regular biochemical tests for five to seven years, and CT and US one year after operation in all patients without confirmed metastases. Main outcome measures: Presence or absence of hepatic metastases. Results: Accuracy of surgical assessment, angiography, US, CT and CTA was 90, 77, 80, 82 and 83%, respectively, and corresponding predictive values of a negative test were 87, 75, 77, 80 and 84%. Measurement of bilirubin concentration and hepatic enzyme activities were not helpful, and that of carcinoembryonic antigen had an accuracy of only 70%. Accuracy and predictive values were not improved by combining tests. Conclusion: The accuracy of US, CT or CTA was not good enough to merrit routine use before operations for colorectal cancer. They are potentially valuable for monitoring progress at follow up, but this remains to be confirmed.
KW - Carcinoembryonic antigen
KW - Colorectal cancer
KW - Imaging methods
KW - Liver function tests
KW - Liver metastases
UR - http://www.scopus.com/inward/record.url?scp=0027218264&partnerID=8YFLogxK
M3 - Article
C2 - 8103361
AN - SCOPUS:0027218264
SN - 1102-4151
VL - 159
SP - 275
EP - 281
JO - European Journal of Surgery, Acta Chirurgica
JF - European Journal of Surgery, Acta Chirurgica
IS - 5
ER -