Abstract
Background
Determination of prognosis in patients with resectable colorectal liver metastases
(CLM) is desirable in order to improve case selection for surgery and tailor adjuvant
treatment according to individual recurrence risk. Conventional clinicopathological
factors lack the sensitivity to accurately achieve this goal. Consideration of tumour
biology and the identification of molecular prognostic markers may allow more accurate
risk stratification.
Method
This systematic review examines evidence from published manuscripts looking at molecular
markers in resectable colorectal liver metastases and their correlation with disease
recurrence and survival following hepatectomy.
Results
Studies have yielded promising results in the search for prognostic molecular markers
of CLM. Molecular biomarkers from varied aspects of tumour biology have been examined
and a number of these, including proliferation indices, telomerase, thymidylate synthase,
microvessel density and thrombospondin-1 appear to have prognostic utility in this
context. Validation of other markers, notably p53, has been limited by a failure of
methodologies to account for their biological complexity.
Conclusions
A biomarker-based approach may yield significant benefits through informed treatment
of resectable metastatic colorectal malignancy. Standardised retrospective analyses
are necessary to confirm preliminary findings and identify existing and novel markers
for inclusion into prospective studies. Assessment and verification of multiple molecular
markers in this manner may allow molecular profiling of metastases and tailoring of
therapy according to the biological aggressiveness of individual tumours. The advent
of genomic- and proteomic-based technologies will allow the simultaneous analysis
of multiple molecular markers and the derivation of disease profiles associated with
disease recurrence and poor survival.
Keywords
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Article info
Publication history
Accepted:
January 3,
2006
Received:
December 4,
2005
Identification
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© 2006 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
