Alcohol consumption enhances liver metastasis in colorectal carcinoma patients.
BACKGROUND
It is important to identify risk factors for liver metastasis in patients with colorectal carcinoma because the liver is the most common site of recurrence. Alcohol consumption reportedly is associated with hematogenous metastasis in certain animal models. Furthermore, some studies have shown that carmofur, a derivative of 5-fluorouracil, is particularly effective as adjuvant chemotherapy for colorectal carcinoma, and may even suppress liver metastasis, although the mechanism by which this occurs remains unknown. In addition, carmofur is known to inhibit alcohol metabolism. To the authors' knowledge, the relation between liver metastasis in colorectal carcinoma and alcohol consumption has not been examined previously. Therefore, the authors studied the relations between liver metastasis in colorectal carcinoma and various clinicopathologic factors including alcohol consumption status.


METHODS
This study was comprised of 133 colorectal carcinoma patients with invasion beyond the submucosal layer who had undergone surgical resection. The subjects were examined and divided into two groups according to the occurrence or absence of liver metastasis. The relations between liver metastasis and other clinicopathologic factors were analyzed by univariate and multivariate statistical methods.


RESULTS
Univariate analysis showed alcohol consumption (P=0.0021) and blood vessel invasion (P=0.0045) were correlated with liver metastasis. Multivariate analysis showed both to be independent risk factors for liver metastasis.


CONCLUSIONS
Alcohol consumption is an independent risk factor for liver metastasis in colorectal carcinoma patients. Therefore, patients with colorectal carcinoma who drink alcohol require intensive examination and follow-up with respect to liver metastasis. Further study is necessary to confirm the effect of adjuvant chemotherapy using carmofur in colorectal carcinoma patients.
Aizawa Hospital, Matsumoto, Japan.
M
M
Maeda
H
H
Nagawa
T
T
Maeda
H
H
Koike
H
H
Kasai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001808:Blood Vessels / Q000473:pathology; D002277:Carcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000431:Ethanol / Q000037:antagonists & inhibitors / Q000378:metabolism; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008113:Liver Neoplasms / Q000517:prevention & control / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000032:analysis
D000970:Antineoplastic Agents; D000431:Ethanol; D005723:gamma-Glutamyltransferase; C017367:carmofur; D005472:Fluorouracil