Echogenic appearance of colorectal liver metastases on intraoperative ultrasonography is associated with survival after hepatic resection

Michelle L. DeOliveira, Timothy M. Pawlik, Ana L. Gleisner, Lia Assumpcaom, Gaspar J. Lopes-Filho, Michael A. Choti

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Survival after resection of colorectal liver metastases has traditionally been associated with clinicopathologic factors. We sought to investigate whether echogenicity of colorectal liver metastasis as assessed by intraoperative ultrasound (IOUS) was a prognostic factor after hepatic resection. Prospective data on tumor IOUS appearance were collected in 84 patients who underwent hepatic resection for colorectal liver metastasis. Images were digitally recorded, blindly reviewed, and scored for echogenicity (hypo-, iso-, or hyperechoic). The median tumor number was 1 and the median tumor size was 5.0 cm. At the time of surgery, the IOUS appearance of the colorectal liver metastases were hypoechoic in 35 (41.7%) patients, isoechoic in 37 (44.0%) patients, and hyperechoic in 12 (14.3%) patients. Traditional clinicopathologic prognostic factors were similarly distributed among the three echogenicity groups (all p∈>∈0.05). Patients with a hypoechoic lesion had a significantly shorter median survival (30.2 months) compared with patients who had either an isoechoic (53.2 months) or hyperechoic (42.3 months) lesion (p∈=∈0.005). The 5-year survival after hepatic resection of colorectal liver metastasis was also associated with the echogenic appearance of the lesion (hypoechoic 14.4 vs isoechoic 37.4 vs hyperechoic 46.2%) (p∈<∈0.05). Intraoperative ultrasound echogenicity should be considered a prognostic factor after hepatic resection of metastatic colorectal cancer.

Original languageEnglish (US)
Pages (from-to)970-976
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume11
Issue number8
DOIs
StatePublished - Aug 2007

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Ultrasonography
Neoplasm Metastasis
Survival
Liver
Neoplasms
Colorectal Neoplasms

Keywords

  • Colorectal metastases
  • Echogenicity
  • Intraoperative ultrasound
  • Prognosis

ASJC Scopus subject areas

  • Surgery

Cite this

Echogenic appearance of colorectal liver metastases on intraoperative ultrasonography is associated with survival after hepatic resection. / DeOliveira, Michelle L.; Pawlik, Timothy M.; Gleisner, Ana L.; Assumpcaom, Lia; Lopes-Filho, Gaspar J.; Choti, Michael A.

In: Journal of Gastrointestinal Surgery, Vol. 11, No. 8, 08.2007, p. 970-976.

Research output: Contribution to journalArticle

DeOliveira, Michelle L. ; Pawlik, Timothy M. ; Gleisner, Ana L. ; Assumpcaom, Lia ; Lopes-Filho, Gaspar J. ; Choti, Michael A. / Echogenic appearance of colorectal liver metastases on intraoperative ultrasonography is associated with survival after hepatic resection. In: Journal of Gastrointestinal Surgery. 2007 ; Vol. 11, No. 8. pp. 970-976.
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abstract = "Survival after resection of colorectal liver metastases has traditionally been associated with clinicopathologic factors. We sought to investigate whether echogenicity of colorectal liver metastasis as assessed by intraoperative ultrasound (IOUS) was a prognostic factor after hepatic resection. Prospective data on tumor IOUS appearance were collected in 84 patients who underwent hepatic resection for colorectal liver metastasis. Images were digitally recorded, blindly reviewed, and scored for echogenicity (hypo-, iso-, or hyperechoic). The median tumor number was 1 and the median tumor size was 5.0 cm. At the time of surgery, the IOUS appearance of the colorectal liver metastases were hypoechoic in 35 (41.7{\%}) patients, isoechoic in 37 (44.0{\%}) patients, and hyperechoic in 12 (14.3{\%}) patients. Traditional clinicopathologic prognostic factors were similarly distributed among the three echogenicity groups (all p∈>∈0.05). Patients with a hypoechoic lesion had a significantly shorter median survival (30.2 months) compared with patients who had either an isoechoic (53.2 months) or hyperechoic (42.3 months) lesion (p∈=∈0.005). The 5-year survival after hepatic resection of colorectal liver metastasis was also associated with the echogenic appearance of the lesion (hypoechoic 14.4 vs isoechoic 37.4 vs hyperechoic 46.2{\%}) (p∈<∈0.05). Intraoperative ultrasound echogenicity should be considered a prognostic factor after hepatic resection of metastatic colorectal cancer.",
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AB - Survival after resection of colorectal liver metastases has traditionally been associated with clinicopathologic factors. We sought to investigate whether echogenicity of colorectal liver metastasis as assessed by intraoperative ultrasound (IOUS) was a prognostic factor after hepatic resection. Prospective data on tumor IOUS appearance were collected in 84 patients who underwent hepatic resection for colorectal liver metastasis. Images were digitally recorded, blindly reviewed, and scored for echogenicity (hypo-, iso-, or hyperechoic). The median tumor number was 1 and the median tumor size was 5.0 cm. At the time of surgery, the IOUS appearance of the colorectal liver metastases were hypoechoic in 35 (41.7%) patients, isoechoic in 37 (44.0%) patients, and hyperechoic in 12 (14.3%) patients. Traditional clinicopathologic prognostic factors were similarly distributed among the three echogenicity groups (all p∈>∈0.05). Patients with a hypoechoic lesion had a significantly shorter median survival (30.2 months) compared with patients who had either an isoechoic (53.2 months) or hyperechoic (42.3 months) lesion (p∈=∈0.005). The 5-year survival after hepatic resection of colorectal liver metastasis was also associated with the echogenic appearance of the lesion (hypoechoic 14.4 vs isoechoic 37.4 vs hyperechoic 46.2%) (p∈<∈0.05). Intraoperative ultrasound echogenicity should be considered a prognostic factor after hepatic resection of metastatic colorectal cancer.

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