Release date: 2006-10-12
A study conducted at the Bronnie Ambroise Pare Hospital in France, led by Benoist and others, raised concerns about the reliability of CT scans in evaluating the response to treatment for liver metastases from colorectal cancer. The research, published in the Journal of Clinical Oncology in 2006, suggests that even when CT imaging shows complete disappearance of metastatic lesions, it may not indicate a true cure. This phenomenon has been referred to as a "false report" in some cases.
Most patients with liver metastases from colorectal cancer are treated with systemic chemotherapy. To better understand the clinical significance of a complete response, a study included 38 patients who had no extrahepatic metastases and fewer than 10 liver lesions before treatment. After chemotherapy, imaging tests such as CT and ultrasound showed that one or more lesions had disappeared. Within four weeks of the imaging, all patients underwent surgery along with intraoperative ultrasound. They were followed up for at least one year post-surgery.
The results revealed that out of 66 lesions that appeared to have completely responded to treatment on CT scans, 20 were still present during surgery. Of the remaining 46 lesions, 15 were surgically removed, and pathological analysis found cancer cells in 12 of them. Another 31 lesions were not removed, and during the one-year follow-up, 23 of these showed local recurrence. Overall, 55 out of the 66 lesions (83%) that looked like they had fully responded to treatment either remained or recurred, indicating that the lesions likely still contained cancer cells.
This study highlights an important issue in oncology: the need for caution when interpreting CT findings after chemotherapy for liver metastases. Even if imaging suggests a complete response, surgical confirmation and long-term follow-up remain essential to assess true treatment success. The findings emphasize the importance of combining imaging with direct surgical evaluation to avoid missing residual disease, which could lead to unnecessary optimism and potentially delayed treatment.
Source: China Medical Tribune
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