[The metastasis of rectal cancer].
Eight hundred and eighty-six cases of rectal cancer diagnosed and reported to the National Cancer Registry in 1980 were submitted to obduction. Metastases were identified in 46.8%. Liver, lung and bones were affected in 38.7%, 16.1 and 3.5% of cases, respectively. Pattern of metastatic spread was determined by histology, with adenocarcinoma giving rise to blood-borne metastases, mucinous adenocarcinoma producing mostly lymphogenic metastases and signet-ring cell carcinoma spreading in either way. Isolated liver involvement was established in 9% of patients showing liver metastases at radical surgery. The parameter reached 22% when cases of presacral recurrence were excluded. A histologically oriented scheme is suggested to assure complete diagnostic coverage of metastases and to develop a concept for the treatment of liver secondaries. Targeted intraperitoneal and endolymphatic application of cytotoxic agents for the treatment of liver metastases aimed at reduction of extrahepatic dissemination is discussed.
Slisow
W
W
Central Institute for Problems of Cancer, Berlin-Buch.
Möhner
M
M
D001344:Autopsy; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009362:Neoplasm Metastasis; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D012007:Rectum / Q000473:pathology / Q000601:surgery