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The tumour biology of synchronous and metachronous colorectal liver metastases: a systematic review

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Abstract

Forty to fifty percent of colorectal cancer (CRC) patients develop colorectal liver metastases (CLM) that are either synchronous or metachronous in presentation. Clarifying whether there is a biological difference between the two groups of liver metastases or their primaries could have important clinical implications. A systematic review was performed using the following resources: MEDLINE from PubMed (1950 to present), Embase, Cochrane and the Web of Knowledge. Thirty-one articles met the inclusion criteria. The review demonstrated that the majority of studies found differences in molecular marker expression between colorectal liver metastases and their respective primaries in both the synchronous and metachronous groups. Studies investigating genetic aberrations demonstrated that the majority of changes in the primary tumour were ‘maintained’ in the colorectal liver metastases. A limited number of studies compared the primary tumours of the synchronous and metachronous groups and generally demonstrated no differences in marker expression. Although there were conflicting results, the colorectal liver metastases in the synchronous and metachronous groups demonstrated some differences in keeping with a more aggressive tumour subtype in the synchronous group. This review suggests that biological differences may exist between the liver metastases of the synchronous and metachronous groups. Whether there are biological differences between the primaries of the synchronous and metachronous groups remains undetermined due to the limited number of studies available. Future research is required to determine whether differences exist between the two groups and should include comparisons of the primary tumours.

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Abbreviations

CLM:

Colorectal liver metastases

CRC:

Colorectal cancer

SCLM:

Synchronous colorectal liver metastases

IHC:

Immunohistochemistry

RT-PCR:

Reverse transcription polymerase chain reaction

2D-DIGE:

Two-dimensional difference gel electrophoresis

FISH:

Fluorescence in situ hybridization

CEBM:

Oxford Centre for Evidence-Based Medicine Levels of Evidence

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Acknowledgments

This review was based on work performed for a MD(Res) degree at Imperial College, London, Division of Surgery and Cancer.

Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Colorectal Surgery, The Royal Marsden Hospital, Fulham Road, London, UK

    A. A. P. Slesser, P. Georgiou & P. Tekkis

  2. Division of Surgery, Imperial College, Chelsea and Westminster Campus, London, UK

    P. Georgiou, S. Mudan & P. Tekkis

  3. Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, UK

    G. Brown

  4. Department of Hepatobiliary Surgery, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK

    S. Mudan

  5. Centre for Pathology, Imperial College at St Mary’s Hospital, Praed Street, London, W2 1NY, UK

    R. Goldin

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  1. A. A. P. Slesser
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Slesser, A.A.P., Georgiou, P., Brown, G. et al. The tumour biology of synchronous and metachronous colorectal liver metastases: a systematic review. Clin Exp Metastasis 30, 457–470 (2013). https://doi.org/10.1007/s10585-012-9551-8

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  • DOI: https://doi.org/10.1007/s10585-012-9551-8

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