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- Title
HP36P DOES NEO-ADJUVANT CHEMOTHERAPY AFFECT THE ACCURACY OF HELICAL CT AND CT PORTOGRAPHY FOR PRE-OPERATIVE PLANNING IN HEPATIC COLORECTAL METASTASES?
- Authors
Adie, S.; Yip, C.; Chu, F.; Morris, D. L.; Modi, D.
- Abstract
Purpose Pre-operative scanning for hepatic colorectal metastases surgery remains a challenge, especially in the age of neo-adjuvant chemo, which has marked biochemical & physical effects on the liver. We investigated helical CT and CT portography as pre-op planning tools. Methodology All patients who had resection of hepatic colorectal metastases between Jan 2004 and June 2006 were included. Patients were divided into those who received neo-adjuvant chemo and those who did not. The number of malignant hepatic lesions found on each scan was compared with those found on histopathology & intra-op ultrasound/examination. Accurate scans (scan lesions = true lesions), over-estimations (scan lesions > true lesions) and under-estimations (scan lesions < true lesions) were recorded. Results 25 patients had pre-op CT portography with neo-adjuvant chemo and 63 without. Accurate scans on a per-patient basis were 2 (8%) for the chemo group vs. 27 (43%) for the non-chemo group, p < 0.002. Notably, there were 17 (68%) over-estimates in the chemo group vs. 25 (40%) in the non-chemo group. There were 6 (24%) vs. 11 (17%) under-estimates respectively. 23 patients had pre-op helical CT with neo-adjuvant chemo and 64 without. Accurate scans on a per-patient basis were 7 (30%) for the chemo group vs. 26 (41%) in the non-chemo group, p = 0.388. There were 8 (35%) over-estimates in the chemo group vs. 12 (19%) in the non-chemo group. There were 8 (35%) vs. 26 (41%) under-estimates respectively. Conclusion While CT portography is useful for detecting occult hepatic metastases, there is evidence that over-estimation of disease is a problem, particularly when neo-adjuvant chemo was used. Helical CT also shows this trend although to a lesser extent.
- Subjects
ABSTRACTS; DRUG therapy; IMMUNOLOGICAL adjuvants; LIVER surgery; LIVER metastasis; MEDICAL radiography; PREOPERATIVE care; SURGICAL excision; THERAPEUTICS
- Publication
ANZ Journal of Surgery, 2007, Vol 77, p48
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/j.1445-2197.2007.04122_36.x