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Diseases of the Colon & Rectum

, Volume 42, Issue 8, pp 1053–1056 | Cite as

Histopathologic characteristics of colorectal cancer with liver metastasis

  • Yosuke Adachi
  • Masafumi Inomata
  • Kenji Kakisako
  • Koichi Sato
  • Norio Shiraishi
  • Seigo Kitano
Original Contributions
  • 38 Downloads

Abstract

PURPOSE: Although prognostic factors of colorectal cancer have been studied, factors associated with liver metastasis have not been fully investigated. The aim of this study was to clarify the histopathologic characteristics of colorectal cancer with liver metastasis. METHODS: We performed a retrospective histopathologic study on 335 patients who underwent resection of colorectal cancer during 15 years. Histopathologic parameters of tumors with liver metastasis were compared with those without liver metastasis. RESULTS: Forty-one patients (12 percent) had simultaneous liver metastasis. Tumors having liver metastasis, when compared with those not having liver metastasis, were characterized by high frequency of tumor size more than 6 cm (51vs. 28 percent;P<0.01), presence of serosal invasion (98vs. 66 percent;P<0.01), lymphatic invasion (34vs. 15 percent;P<0.01), venous invasion (24vs. 3 percent;P<0.01), and lymph node metastasis (85vs. 39 percent;P<0.01). Multivariate analysis showed that factors independently associated with liver metastasis were serosal invasion, venous invasion, and lymph node metastasis. Accuracy in the diagnosis of liver metastasis was highest for venous invasion (88 percent) and lowest for serosal invasion (41 percent). Among 98 patients with both serosal invasion and lymph node metastasis, tumors with and without liver metastasis were different in frequency of venous invasion (26vs. 6 percent;P<0.01) and extracolic lymph node metastasis (68vs. 47 percent;P<0.05). CONCLUSION: In colorectal cancer important factors associated with liver metastasis were serosal invasion, venous invasion, and lymph node metastasis. Significant determinants for liver metastasis from colorectal cancer were venous invasion and extracolic lymph node metastasis.

Key words

Colorectal cancer Liver metastasis Histopathology Venous invasion Lymph node metastasis 

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References

  1. 1.
    Swinton NW, Legg MA, Lewis FG. Metastasis of cancer of the rectum and sigmoid flexure. Dis Colon Rectum 1964;7:273–7.Google Scholar
  2. 2.
    Cedermark BJ, Schultz SS, Bakshi S, Parthasarathy KL, Mittelman A, Evans JT. Value of liver scan in the follow-up study of patients with adenocarcinoma of the colon and rectum. Surg Gynecol Obstet 1977;144:745–8.PubMedGoogle Scholar
  3. 3.
    Japanese Research Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. Jpn J Surg 1983;13:557–73.Google Scholar
  4. 4.
    Adachi Y, Aramaki M, Kawano K, Shiraishi N, Kitano S, Kaketani K. Small sigmoid colon cancer with liver metastasis [letter]. J Clin Gastroenterol 1999;28:278.CrossRefPubMedGoogle Scholar
  5. 5.
    Chapuis PH, Dent OF, Fisher R,et al. A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer. Br J Surg 1985;72:698–702.PubMedGoogle Scholar
  6. 6.
    Takebayashi Y, Akiyama S, Yamada K,et al. Angiogenesis as an unfavorable prognostic factor in human colorectal carcinoma. Cancer 1996;78:226–31.CrossRefPubMedGoogle Scholar
  7. 7.
    Pricolo VE, Finkelstein SD, Hansen K, Cole BF, Bland KI. Mutated p53 gene is an independent adverse predictor of survival in colon carcinoma. Arch Surg 1997;132:371–5.PubMedGoogle Scholar
  8. 8.
    Mori M, Barnard GF, Mimori K, Ueo H, Akiyoshi T, Sugimachi K. Overexpression of matrix metalloproteinase-7 mRNA in human colon carcinomas. Cancer 1995;75:1516–9.PubMedGoogle Scholar
  9. 9.
    Talbot IC, Ritchie S, Leighton MH, Hughes AO, Bussey HJ, Morson BC. The clinical significance of invasion of veins by rectal cancer. Br J Surg 1980;67:439–42.PubMedGoogle Scholar
  10. 10.
    Shirouzu K, Isomoto H, Kakegawa T, Morimatsu M. A prospective clinicopathologic study of venous invasion in colorectal cancer. Am J Surg 1991;162:216–22.CrossRefPubMedGoogle Scholar
  11. 11.
    Inoue T, Mori M, Shimono R, Kuwano H, Sugimachi K. Vascular invasion of colorectal carcinoma readily visible with certain stains. Dis Colon Rectum 1992;35:34–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Ouchi K, Sugawara T, Ono H,et al. Histologic features and clinical significance of venous invasion in colorectal carcinoma with hepatic metastasis. Cancer 1996;78:2313–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Phillips RK, Hittinger R, Blesovsky L, Fry JS, Fielding LP. Large bowel cancer: surgical pathology and its relationship to survival. Br J Surg 1984;71:604–10.PubMedGoogle Scholar
  14. 14.
    Wolmark N, Fisher B, Wieand HS. The prognostic value of the modifications of the Dukes' C class of colorectal cancer. Ann Surg 1986;203:115–22.PubMedGoogle Scholar
  15. 15.
    Galandiuk S, Wieand HS, Moertel CG,et al. Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 1992;174:27–32.PubMedGoogle Scholar
  16. 16.
    Adachi Y, Mori M, Matsushima T,et al. The distribution of lymph node metastases in right-sided colon cancer. J Clin Gastroenterol 1994;19:210–3.PubMedGoogle Scholar

Copyright information

© The American Society of Colon and Rectal Surgeons 1999

Authors and Affiliations

  • Yosuke Adachi
    • 1
  • Masafumi Inomata
    • 1
  • Kenji Kakisako
    • 1
  • Koichi Sato
    • 1
  • Norio Shiraishi
    • 1
  • Seigo Kitano
    • 1
  1. 1.First Department of SurgeryOita Medical UniversityOitaJapan

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