Shifting from clinical to biologic indicators of prognosis after resection of hepatic colorectal metastases

Curr Oncol Rep. 2007 May;9(3):193-201. doi: 10.1007/s11912-007-0021-4.

Abstract

Following resection of hepatic colorectal metastases, there are few criteria for predicting which patients have more aggressive disease and are, therefore, more likely to experience recurrence and reduced survival. Traditionally, primary tumor stage, preoperative carcinoembryonic antigen level, time from primary tumor treatment to diagnosis of hepatic metastases (disease-free interval), hepatic tumor size, number of hepatic metastases, and presence of extrahepatic disease have been reported to be predictors of survival after resection. However, the data regarding the prognostic importance of these clinicopathologic factors are inconsistent and conflicting. Therefore, conventional clinicopathologic factors may be inadequate for the purposes of prognostication. More recently, there has been increased interest in identifying biologic indicators that may help better define patients at risk for recurrence after hepatic resection for colorectal metastases. Recent studies have shown that proliferation markers such as p53 expression, tritiated thymidine uptake, thymidylate synthase, Ki-67, and human telomerase reverse transcriptase may be better predictors of outcome after resection of hepatic colorectal metastases. Moreover, tumor response to preoperative chemotherapy may also prove to be a useful predictor of outcome following liver resection for colorectal metastases.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / metabolism
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery
  • Disease-Free Survival
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Prognosis
  • Survival Analysis

Substances

  • Biomarkers, Tumor