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Title: Improved detection of hepatic metastases at the time of curative resection of colorectal cancer by iodised oil emulsion enhanced computerised tomography and intraoperative ultrasonography
Author: Miles, W. F. Anthony
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1996
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This thesis proposes that IOUSS is as accurate as IOE scanning in the detection of small metastases at the time of primary colon resection, and that IOE scanning in the follow up period will detect new metastases as they develop. Patients who have metastases detected in this way will be suitable for hepatic resection and have an improved 5 year survival. The detailed staging of patients with regard to hepatic metastases has been used to clarify the relationship between the presence of hepatic metastases, and elevation in the level of serum CEA. IOUSS is shown to be as accurate as IOE scanning in the detection of patients with metastases at the time of operation. IOUSS detects more patients with metastases than IOE, this difference does not reach statistical significance. IOE scanning can detect the appearance and growth of metastases in patients following colonic resection. IOE scanning cannot be used as a routine form of follow up as patients are reluctant to undergo repeated scans over a two year period, recruitment to this part of the study was very poor. IOE scanning and IOUSS are able to detect very small hepatic metastases as the only site of recurrence in patients following colonic surgery. Two patients with small metastases went on to have a hepatic resection. Unfortunately both of these patients died within 2 years of hepatic surgery. Early detection of metastases by IOE and IOUSS scanning did not therefore improve patients survival. The results of IOE scanning and IOUSS have been used to define levels of serum CEA which are likely to be related to the presence of hepatic metastases both at the time of colonic resection and during follow up. In conclusion IOUSS is a sensitive and accurate method of detecting hepatic metastases from colorectal cancer at the time of operation. This information could not be used to improve survival. The appearance of hepatic metastases is related to the elevation of serum CEA.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available