Abstract
A surgical resection of metastatic liver lesions from colorectal cancer contributes to an improved prognosis. However, the postoperative recurrence rate remains high, particularly in the residual liver. This is probably the result of the failure to detect small lesions. In the present study, we histologically examined the presence of intrahepatic micrometastases, which are considered to be related to recurrence in the residual liver. Intrahepatic micrometastases were histologically examined in 31 resected specimens of 25 patients undergoing a hepatic resection because of metastasis to the liver from colorectal cancer. Micrometastases were found in 14 of 25 cases (56.0%). They were located in the portal veins, central veins, sinusoid, and bile ducts. The longest distance from the main metastasis was 38.2 (mean 7.5±8.0) mm. The size of the macrometastases became larger, and the frequency of micrometastases and the distance of micrometastases from macrometastases had a tendency to increase. Continuous invasion of the macrometastases into the micrometastases through the vasculature or bile duct was also observed. These results suggested that some micrometastases observed in the metastatic liver from colorectal cancer were thus seeded from the primary lesions, while other micrometastases originated from the macrometastatic lesions as satellite lesions.
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References
Welch JP, Donaldson GA (1979) Clinical correlation of an autopsy study of recurrent colorectal cancer. Ann Surg 189: 496–502
Habib NA, Koh MK, Zografos G, Awad RW, Bottino G (1993) Elective hepatic resection for benign and malignant liver disease: early results. Br J Surg 80:1039–1041
Sugihara K, Hojo K, Moriya Y, Yamasaki S, Kosuge T, Takayama T (1993) Pattern of recurrence after hepatic resection for colorectal metastases. Br J Surg 80:1032–1035.
Tsuzuki T, Ogata Y, Iida S, Shimazu M (1984) Hepatic resection in 125 patients. Arch Surg 119:1025–1032
Azuhata H, Mori M, Matsumoto N, Umeda H, Kato H, Takahashi N, Iida T, Imamura H, Naritaka Y, Kikuchi T, Haga S, Kajiwara T (1989) A study of treatment for liver metastasis of colorectal carcinoma (in Japanese with English abstract). Nihon Daichyo Koumonbyo Kaishi (J Jpn Soc Colo-proctol) 42:505–509
Hamano K, Igarashi T, Akimoto S, Kameoka S (1987) The treatment of liver metastases from colo-rectal cancer with various stagings (in Japanese). Shyokaki Geka (Gastroenterol Surg) 10:817–821
Van Ooijen B, Wiggers T, Meijer S, Van der Heijde MN, Slooff MJH, Van de Velde CJH, Obertop H, Gouma DJ, Brugging EDM, Lange JF, Munting JDK, Rutten APM, Rutten HJT, De Vries JE, Groot G, Zoetmulder FAN, Van Putten WLJ (1992) Hepatic resection for colorectal metastases in the Netherlands: a multi-institutional 10 year study. Cancer 70:28–34
Hatsuse K, Komiyama A, Kunimatsu N, Maemura M, Aoki H, Yamamoto S, Kakihara M, Hase K, Mochizuki H, Tamakuma S (1991) Study of multiple factors for prognosis and recurrence after hepatic resection for metastasis from colorectal cancer (in Japanese with English abstract). Nihon Shyokakigeka Gakkai Zasshi (Jpn J Gastroenterol Surg) 24:824–830
Takahashi T, Seki M, Azekura K, Ohta H, Nishi M, Kajitani T (1987) Surgical treatment of liver metastasis of colon and rectal cancer (in Japanese). Shyokaki Geka (Gastroenterol Surg): 10:839–844
Akimoto S (1992) Ultrasonic diagnosis of hepatic diseases (in Japanese). Shyokaki Geka (Gastroenterol Surg) 15:1981–1990
Nishida O, Shiroto H, Gondoh H, Isai H, Satoh N, Manabe K, Kondoh Y, Sano F, Uchino J (1988) Concept of major resection for metastatic liver cancer from colorectum (in Japanese). Nihon Shyokakigeka Gakkai Zasshi (Jpn J Gastroenterol Surg) 21:1061–1067
Isono T, Miyazaki M, Udagawa I, Koshikawa H, Iinuma K, Itoh H, Nakajima T, Kaiho T, Suzuki H, Koyama T, Shimoda T, Nakagawa K, Okui K (1992) The clinicopathological study of intrahepatic micrometastases in hepatic metastatic carcinoma: comparison between hepatic metastases of gastric cancer and of colorectal cancer (in Japanese with English abstract). Nihon Gan Chiryo Gakkaishi (J Jpn Soc Cancer Ther) 27:893–899
Shibata H (1989) A histopathological investigation of metastatic liver tumors: the classification of their histological patterns and metastatic pathways taking into account the microscopic metastatic foci (in Japanese with English abstract). Gan No Rinsho (Jpn J Cancer Clin) 35:335–347
Shimazu M, Aoki H, Maruta M, Komori Y, Hasumi A, Sugenoya H, Nakano M, Kawata S, Yoshimatsu Y, Hayashi O, Suzuki J, Hashimura K (1989) Hepatic resection for metastases from colorectal cancer: its significance and problems (in Japanese). Nihon Shyokakigeka Gakkai Zasshi (Jpn J Gastroenterol Surg) 22:1826–1833
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Nanko, M., Shimada, H., Yamaoka, H. et al. Micrometastatic colorectal cancer lesions in the liver. Surg Today 28, 707–713 (1998). https://doi.org/10.1007/BF02484616
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DOI: https://doi.org/10.1007/BF02484616