Indicators of recurrence following cryotherapy for hepatic metastases from colorectal cancer
| Autor: | Joachim K. Seifert, David L. Morris |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Colorectal cancer medicine.medical_treatment Rectum Cryotherapy Gastroenterology Disease-Free Survival Metastasis Carcinoembryonic antigen Internal medicine medicine Humans Aged Retrospective Studies Analysis of Variance Lung biology business.industry Incidence (epidemiology) Liver Neoplasms Middle Aged Prognosis medicine.disease Carcinoembryonic Antigen Surgery medicine.anatomical_structure biology.protein Female Neoplasm Recurrence Local Colorectal Neoplasms business |
| Zdroj: | British Journal of Surgery. 86:234-240 |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1046/j.1365-2168.1999.00995.x |
| Popis: | Background This retrospective review aimed to assess the incidence of local recurrence at the cryosite, hepatic and extrahepatic recurrence and the corresponding disease-free intervals. Prognostic indicators following hepatic cryotherapy were also identified. Methods Eighty-five patients underwent complete cryotreatment of colorectal liver metastases between April 1990 and May 1997. Possible prognostic indicators were tested for their impact on the disease-free interval at the cryosite, liver disease-free survival and overall disease-free survival with univariate and multivariate analysis. Results At a median follow-up of 22 months 66 patients developed tumour recurrence: 18 in the liver only; 15 in the liver and lung; 22 in the liver and extrapulmonary areas; and 11 at extrahepatic sites only. Local recurrence at the cryosite occurred in 28 patients. Cryotreated metastases larger than 3 cm were associated with a shorter disease-free interval at the cryosite and liver disease-free survival; persistently raised serum carcinoembryonic antigen (CEA) levels after operation were associated with shorter liver disease-free and overall disease-free intervals in multivariate analysis. Conclusion Improvements in probe placement and monitoring of the freezing process are required to allow successful treatment of large liver metastases. A failure in complete postoperative CEA response indicates that hepatic or extrahepatic disease was not detected before operation, which may be avoided with better staging procedures. |
| Databáze: | OpenAIRE |
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