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Br J Surg. 2012 Apr;99(4):477-86. doi: 10.1002/bjs.8667. Epub 2012 Jan 19.

Systematic review and meta-analysis of follow-up after hepatectomy for colorectal liver metastases.

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  • 1Division of Surgery and Oncology, School of Cancer Studies, University of Liverpool, Liverpool, UK. robjones@liv.ac.uk

Abstract

BACKGROUND:

The evidence surrounding optimal follow-up after liver resection for colorectal metastases remains unclear. A significant proportion of recurrences occur in the early postoperative period, and some groups advocate more intensive review at this time.

METHODS:

A systematic review of literature published between January 2003 and May 2010 was performed. Studies that described potentially curative primary resection of colorectal liver metastases that involved a defined follow-up protocol and long-term survival data were included. For meta-analysis, studies were grouped into intensive (more frequent review in the first 5 years after resection) and uniform (same throughout) follow-up.

RESULTS:

Thirty-five studies were identified that met the inclusion criteria, involving 7330 patients. Only five specifically addressed follow-up. Patients undergoing intensive early follow-up had a median survival of 39·8 (95 per cent confidence interval 34·3 to 45·3) months with a 5-year overall survival rate of 41·9 (34·4 to 49·4) per cent. Patients undergoing routine follow-up had a median survival of 40·2 (33·4 to 47·0) months, with a 5-year overall survival rate of 38·4 (32·6 to 44·3) months.

CONCLUSION:

Evidence regarding follow-up after liver resection is poor. Meta-analysis failed to identify a survival advantage for intensive early follow-up.

Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

PMID:
22261895
[PubMed - indexed for MEDLINE]
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