Detectie van synchrone en metachrone levermetastasen bij colorectaalcarcinoom: Echo versus CT.

Kooijman, W. (Wouter) (2014) Detectie van synchrone en metachrone levermetastasen bij colorectaalcarcinoom: Echo versus CT. thesis, Medicine.

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Abstract

Background: In primary colorectal cancer (CRC), 10-20% patients present with synchronous liver metastases. There has been a trend in the primary detection modality for liver metastases from abdominal ultrasound (US) towards abdominal computed tomography (CT). However, it is not yet clarified whether CT results in an increased detection of synchronous liver metastases, and consequently in a decreased detection of metachronous liver metastases. The aim of our study is to evaluate detection rates of synchronous and metachronous liver metastases with CT and US. Materials & Methods: We performed a retrospective cohort study, in which we included patients that underwent elective colorectal surgery with curative intent for CRC in 2008 and 2011 in our hospital. Patients were divided into two groups, based on the primary detection device for liver metastasis. Follow-up data were available of all patients for a period of at least two years. Results: A total of 550 patients were included in our study, 290 patients underwent primary screening for liver metastases with US; 260 patients with CT. No significant difference was found in detection rate of synchronous liver metastases between primary screening with US and CT (p= 0.11). With normal findings on CT or US at onset, patients presenting with metachronous liver metastasis were similar (p=0.52). Furthermore, the time interval to detect metachronous metastasis was comparable for both screening devices, 13.5 months for US and 9.5 months for CT (p=0.17) during 2 years of follow-up. Conclusion: US is a sufficient detection modality for synchronous metastases. It performed as well as CT in detecting synchronous liver metastases in patients with CRC. Primary screening by US did not result in a higher amount of detected metachronous liver metastases during a 2 year follow-up. Also there was no significant difference in time to detect metachronous liver metastases between both modalities. Therefore, due to lower costs and absence of radiation exposure, US should be preferred as the primary detection modality for synchronous liver metastases in patients with CRC.

Item Type:	Thesis (Thesis)
Supervisor name:	Baal, Dr. J.G. van
Supervisor name:	Weerink, Drs. L.B.M. and Kouwenhoven, Dr. E.A. and Afdeling chirurgie and ZGT Almelo
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:57
Last Modified:	25 Jun 2020 10:57
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1717

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