Portal de Periódicos da CAPES

Systematic review and meta-analysis of follow-up after hepatectomy for colorectal liver metastases2

2012; Oxford University Press; Volume: 99; Issue: 4 Linguagem: Inglês

10.1002/bjs.8667

1365-2168

Robert Jones, Richard Jackson, Declan F.J. Dunne, Hafiz Malik, Stephen Fenwick, Graeme J. Poston, Paula Ghaneh,

Cholangiocarcinoma and Gallbladder Cancer Studies

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.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.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.Evidence regarding follow-up after liver resection is poor. Meta-analysis failed to identify a survival advantage for intensive early follow-up.