BRIEF REPORT
Absence of Colorectal Cancer Metastasis to the Cirrhotic Liver Shoji Uetsuji, MO, Manabu Yamamura, MD, Keigo Yamamichi, MD, Yoshinori Okuda, MD, Hideho Takada, MD, Koshiro Hioki, ~D, MoriguchiCity,Osaka,Japan
Hepatic metastasis of colorectal cancer was found in 4 0 ( 1 6 % ) of 2 5 0 patients with colorectal cancer treated in our department during the past 5 years. Liver cirrhosis was not found among the 4 0 patients with metastases ( 1 6 % ) but was present in 4 6 ( 2 1 . 9 % ) of the 2 1 0 nonmetastatic patients, with a significant difference between the two groups (p < 0 . 0 0 1 ). The rate of patients who were positive for hepatitis B surface antibody was 10% in the metastatic group and 34.3% in the nonmetastatic group, with a significant difference (p < 0 . 0 1 ) . These findings suggest that colorectal cancer does not metastasize to the injured liver, especially the cirrhotic liver.
ecently, aggressive surgical treatment of resectable R colorectal cancer metastatic to the liver has been undertaken because colorectal cancer seldom metasta-
sizes to the cirrhotic liver. The present investigation was performed in an attempt to discover whether colorectal cancer metastasizes to the cirrhotic liver. Between January 1986 and December 1990, 250 patients with colorectal cancer were treated in our department. Hepatic metastases were found in 40 of the 250 patients (metastatic group) but not in the remaining 210 (nonmetastatic group). The two groups were compared with respect to age distribution, sex ratio, presence or absence of liver cirrhosis, and the rate of patients found to be positive for hepatitis B surface (HBs) antibody. The diagnosis of liver cirrhosis was made on the basis of the following laboratory parameters: total bilirubin of 1.5 mg/dL or more, albumin of 3.5 g / d L or less, cholinesterase of 3,500 I U / L or less, 3,-glutamyl transpeptidase of 46 I U / L or more, and indocyanine green retention rate at 15 minutes (ICGR15) of 15% or more. The presence of all these parameters was required to confirm the diagnosis of liver cirrhosis. Furthermore, the histologic diagnosis concerning the presence of a cirrhotic or noncirrhotic liver in all 40 patients with hepatic metastases was made by operative specimen or needle biopsy. The x 2 test was used to detect significant differences between the two groups, and p values of less than 0.05 were considered significant. There were no significant differences between the two groups with respect to age distribution or sex ratio (Table I). Associated liver cirrhosis was not found in the metastatic group but was present in 46 patients (21.9%) in the nonmetastatic group, with the difference being significant (p
Absence of Colorectal Cancer Metastasis to the Cirrhotic Liver Shoji Uetsuji, MO, Manabu Yamamura, MD, Keigo Yamamichi, MD, Yoshinori Okuda, MD, Hideho Takada, MD, Koshiro Hioki, ~D, MoriguchiCity,Osaka,Japan
Hepatic metastasis of colorectal cancer was found in 4 0 ( 1 6 % ) of 2 5 0 patients with colorectal cancer treated in our department during the past 5 years. Liver cirrhosis was not found among the 4 0 patients with metastases ( 1 6 % ) but was present in 4 6 ( 2 1 . 9 % ) of the 2 1 0 nonmetastatic patients, with a significant difference between the two groups (p < 0 . 0 0 1 ). The rate of patients who were positive for hepatitis B surface antibody was 10% in the metastatic group and 34.3% in the nonmetastatic group, with a significant difference (p < 0 . 0 1 ) . These findings suggest that colorectal cancer does not metastasize to the injured liver, especially the cirrhotic liver.
ecently, aggressive surgical treatment of resectable R colorectal cancer metastatic to the liver has been undertaken because colorectal cancer seldom metasta-
sizes to the cirrhotic liver. The present investigation was performed in an attempt to discover whether colorectal cancer metastasizes to the cirrhotic liver. Between January 1986 and December 1990, 250 patients with colorectal cancer were treated in our department. Hepatic metastases were found in 40 of the 250 patients (metastatic group) but not in the remaining 210 (nonmetastatic group). The two groups were compared with respect to age distribution, sex ratio, presence or absence of liver cirrhosis, and the rate of patients found to be positive for hepatitis B surface (HBs) antibody. The diagnosis of liver cirrhosis was made on the basis of the following laboratory parameters: total bilirubin of 1.5 mg/dL or more, albumin of 3.5 g / d L or less, cholinesterase of 3,500 I U / L or less, 3,-glutamyl transpeptidase of 46 I U / L or more, and indocyanine green retention rate at 15 minutes (ICGR15) of 15% or more. The presence of all these parameters was required to confirm the diagnosis of liver cirrhosis. Furthermore, the histologic diagnosis concerning the presence of a cirrhotic or noncirrhotic liver in all 40 patients with hepatic metastases was made by operative specimen or needle biopsy. The x 2 test was used to detect significant differences between the two groups, and p values of less than 0.05 were considered significant. There were no significant differences between the two groups with respect to age distribution or sex ratio (Table I). Associated liver cirrhosis was not found in the metastatic group but was present in 46 patients (21.9%) in the nonmetastatic group, with the difference being significant (p
