The preoperative liver scan and surgical decision-making in patients with colorectal cancer

The influence of preoperative liver scans and liver function tests on surgical decision-making was analyzed in 196 patients who underwent surgical therapy for colorectal cancer. One hundred and thirteen patients who had preoperative liver scans were compared with 83 patients who did not. No statistically significant difference existed between the liver scan group and the nonscan group in terms of when surgical decision-making occurred. Likewise, the results of the liver scan did not influence when operative decisions were made. The majority of decision-making occurred intraoperatively when ultimate confirmation of the presence or absence of hepatic metastases was made. Presumptive surgical decisions were made preoperatively, but final decisions occurred intraoperatively when all relevant patient data could be correlated. Liver scanning has limited usefulness in the preoperative evaluation of patients with colon cancer as it does not affect decision-making and is much more costly than liver function testing.