The identification of patients at high risk following curative resection for colorectal carcinoma.

Thirty-five consecutive patients undergoing apparently curative resection for colorectal carcinoma were staged by conventional methods (Dukes', degree of tumor differentiation and pre- and postoperative CEA). In addition, the presence or absence of occult hepatic metastases at the time of surgery was determined by sequential CT scanning. Thirteen patients died within 30 months of surgery. Conventional prognostic indices failed to define clearly those patients who died. In contrast, the presence or absence of occult hepatic metastases at the time of surgery clearly defined two groups of patients. Only 9 per cent of patients who possessed occult hepatic metastases survived 30 months compared with 88 per cent of patients in whom these metastases were not detected. The clinical implications of these results are discussed.