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. 2024 Mar;106(3):213-218.
doi: 10.1308/rcsann.2023.0027. Epub 2023 May 23.

Postoperative surveillance after surgery for colorectal liver metastasis: a cross-sectional study

I C Nzenwa  1 , S Pathak  2 , S R Knight  3 , N G Mowbray  4 , D O'Reilly  5 , R P Jones  5
Affiliations

Postoperative surveillance after surgery for colorectal liver metastasis: a cross-sectional study

I C Nzenwa et al. Ann R Coll Surg Engl. 2024 Mar.

Abstract

Introduction: Colorectal liver metastases (CRLM) are associated with a high recurrence rate after surgery. There is paucity of high-quality evidence regarding the nature and overall benefit of surveillance after hepatectomy for CRLM. As part of a broader programme of research, this study aimed to assess current strategies for surveillance after liver resection for CRLM and outline surgeons' opinions regarding the benefit of postoperative surveillance.

Methods: An online survey was sent to clinicians performing surgery for CRLM at tertiary hepatobiliary centres in the UK.

Results: There were responses from a total of 23 centres (88% response rate); 15/23 centres used standardised surveillance protocols for all patients. Most centres followed patients up at six months, but there is variation in postoperative surveillance at 3, 9, 18 and beyond 60 months. Patient comorbidities, indeterminate findings on imaging, margin status and assessment of recurrence risk were identified as the major factors influencing personalised surveillance strategies. There was clear clinician equipoise regarding the costs and benefits of surveillance.

Conclusion: There is heterogeneity in postoperative follow-up for CRLM in the UK. High-quality prospective studies and randomised trials are necessary to elucidate the value of postoperative surveillance and identify optimal follow-up strategies.

Keywords: Colorectal Neoplasms; General Surgery; Hepatectomy.

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Figures

Figure 1
Figure 1
Investigations used for surveillance after surgery for CRLM, including the timepoints at which each modality was used CRLM = colorectal liver metastases; CT = computed tomography; PET-CT = positron emission tomography/computed tomography; USS = ultrasound scan
Figure 2
Figure 2
Surgeons’ perceptions regarding postoperative surveillance for CRLM CRLM = colorectal liver metastases
See this image and copyright information in PMC

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