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 effectiveness of treatment for liver metastases from colorectal cancer. The research, published in *J Clin Oncol* in 2006, found that even when CT imaging showed complete disappearance of metastatic lesions, it did not necessarily mean the cancer was fully cured. This phenomenon has been referred to as a "false report" in some cases.
Most patients with liver metastases from colorectal cancer undergo systemic chemotherapy. To better understand the true meaning of a complete response in these patients, researchers studied 38 individuals 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 scan, each patient underwent surgery combined with intraoperative ultrasound. All participants were followed up for at least one year post-surgery.
The findings revealed that 66 liver metastases appeared to have completely responded to treatment based on imaging. However, during surgery, 20 of these lesions were still present. Of the remaining 46, 15 were surgically removed, and pathology confirmed the presence of cancer cells in 12 of them. Another 31 lesions were not removed, and within one year, 23 of those showed signs of local recurrence. Overall, 55 out of the 66 lesions that looked like they had fully responded to treatment were either persistent, residual, or had recurred.
This study highlights an important limitation in using CT scans alone to determine the success of treatment for liver metastases. It suggests that even if imaging shows a complete response, there may still be residual cancer cells, which means surgical removal is often necessary to improve long-term outcomes. These findings emphasize the importance of combining imaging results with pathological analysis and long-term follow-up in managing colorectal cancer liver metastases.
Source: China Medical Tribune
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