Systematic review

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

  1. R. P. Jones1,3,*,
  2. R. Jackson2,
  3. D. F. J. Dunne3,
  4. H. Z. Malik3,
  5. S. W. Fenwick3,
  6. G. J. Poston3,
  7. P. Ghaneh1

Article first published online: 19 JAN 2012

DOI: 10.1002/bjs.8667

Additional Information

How to Cite

Jones, R. P., Jackson, R., Dunne, D. F. J., Malik, H. Z., Fenwick, S. W., Poston, G. J. and Ghaneh, P. (2012), Systematic review and meta-analysis of follow-up after hepatectomy for colorectal liver metastases. British Journal of Surgery. doi: 10.1002/bjs.8667

Author Information

  1. 1

    Division of Surgery and Oncology, School of Cancer Studies, University of Liverpool, Liverpool, UK

  2. 2

    Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK

  3. 3

    Department of Hepatobiliary Surgery, Aintree University Hospital NHS Foundation Trust, Liverpool, UK

*Division of Surgery and Oncology, School of Cancer Studies, University of Liverpool, 5th Floor UCD Building, Daulby Street, Liverpool L69 3GA, UK.

  1. †

    Presented to the BJS Prize Session of the Annual Meeting of the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, Belfast, UK, September 2011; published in abstract form as Br J Surg 2011; 98(Suppl 7): 1

Publication History

  1. Article first published online: 19 JAN 2012
  2. Manuscript Accepted: 30 NOV 2011

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No advantage for intense early follow-up

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.

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