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Intraoperative Ultrasound Staging for Colorectal Liver Metastases in the Era of Liver-Specific Magnetic Resonance Imaging: Is It Still Worthwhile?
Joint Authors
Giuliante, Felice
Langella, Serena
Ardito, Francesco
Russolillo, Nadia
Panettieri, Elena
Perotti, Serena
Mele, Caterina
Ferrero, Alessandro
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-09-22
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background.
To assess the efficacy of intraoperative ultrasound (IOUS) compared with liver-specific magnetic resonance imaging (MRI) in patients with colorectal liver metastases (CRLMs).
Methods.
From January 2010 to December 2017, 721 patients underwent MRI as a part of preoperative workup within 1 month before hepatectomy and were considered for the study.
Early intrahepatic recurrence (relapse at cut surface excluded) was assessed 6 months after the resection and was considered as residual disease undetected by IOUS and/or MRI.
IOUS and MRI performance was compared on a patient-by-patient basis.
Long-term results were also studied.
Results.
A total of 2845 CRLMs were detected by MRI, and the median number of CRLMs per patient was 2 (1–31).
Preoperative chemotherapy was administered in 489 patients (67.8%).
In 177 patients, 379 new nodules were intraoperatively found and resected.
Among 379 newly identified nodules, 317 were histologically proven CRLMs (11.1% of entire series).
The median size of new CRLMs was 6 ± 2.5 mm.
Relationships between intrahepatic vessels and tumors differed between IOUS and MRI in 128 patients (17.7%).
The preoperative surgical plan was intraoperatively changed for 171 patients (23.7%).
Overall, early intrahepatic recurrence occurred in 8.7% of cases.
To assess the diagnostic performance, 24 (3.3%) recurrences at the cut surface were excluded; thus, 5.4% of early relapses were considered for analysis.
The sensitivity of IOUS was superior to MRI (94.5% vs 75.1%), while the specificity was similar (95.7% vs 95.9%).
Multivariate analysis at the hepatic dome or subglissonian and mucinous histology revealed predictive factors of metastases missing at MRI.
The 5-year OS (52.1% vs 37.8%, p=0.006) and DF survival (45.1% vs 33%, p=0.002) were significantly worse among patients with new CRLMs than without.
Conclusions.
IOUS improves staging in patients undergoing resection for CRLMs even in the era of liver-specific MRI.
Intraoperative detection of new CRLMs negatively affects oncologic outcomes.
American Psychological Association (APA)
Langella, Serena& Ardito, Francesco& Russolillo, Nadia& Panettieri, Elena& Perotti, Serena& Mele, Caterina…[et al.]. 2019. Intraoperative Ultrasound Staging for Colorectal Liver Metastases in the Era of Liver-Specific Magnetic Resonance Imaging: Is It Still Worthwhile?. Journal of Oncology،Vol. 2019, no. 2019, pp.1-8.
https://search.emarefa.net/detail/BIM-1183909
Modern Language Association (MLA)
Langella, Serena…[et al.]. Intraoperative Ultrasound Staging for Colorectal Liver Metastases in the Era of Liver-Specific Magnetic Resonance Imaging: Is It Still Worthwhile?. Journal of Oncology No. 2019 (2019), pp.1-8.
https://search.emarefa.net/detail/BIM-1183909
American Medical Association (AMA)
Langella, Serena& Ardito, Francesco& Russolillo, Nadia& Panettieri, Elena& Perotti, Serena& Mele, Caterina…[et al.]. Intraoperative Ultrasound Staging for Colorectal Liver Metastases in the Era of Liver-Specific Magnetic Resonance Imaging: Is It Still Worthwhile?. Journal of Oncology. 2019. Vol. 2019, no. 2019, pp.1-8.
https://search.emarefa.net/detail/BIM-1183909
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1183909