title: The impact of liver metastasis on mortality in patients initially diagnosed with locally advanced or resectable pancreatic cancer.
abstract: BACKGROUND
  Liver metastases are frequent in pancreatic cancer, although their impact on patient mortality is still unclear.
  
  
  METHODS
  The extent of liver metastasis (H-III [diffuse], H-II [moderate], H-I [limited], H-0) and the magnitude of liver dysfunction (lf-III [failure], lf-II [severe], lf-I [moderate], lf-0) were reviewed in 89 locally advanced and resectable pancreatic cancer patients in order to determine possible relationships with mortality and survival.
  
  
  RESULTS
  The extent of liver metastasis (H-III, 18; H-II, 20; H-I, 12; H-0, 39) and the magnitude of liver dysfunction (lf-III, 12; lf-II, 8; lf-I, 11; lf-0, 58) were quite variable. Based on the aforementioned two categories, pancreatic cancer patients could be divided into four groups: (A) extensive liver metastasis affecting patient mortality, 14% (12/89); (B) liver metastases that do not cause severe liver dysfunction, 38% (34/89); (C) severe liver dysfunction, not associated with liver metastasis, 9% (8/89); (D) spared liver function, with no liver metastasis, 39% (35/89). The median survival period of H-III patients (195 d) was quite short compared with those of H-I (288 d) and H-0 (240 d) patients.
  
  
  CONCLUSIONS
  Considering patients with locally advanced and resectable pancreatic cancer, the fraction of cases with diffuse liver metastases is relatively small. Moreover, only a minor proportion of pancreatic cancer patients die from hepatic failure as a direct result of liver metastasis.
authors.affiliation: Hepato-Biliary-Pancreatic Division, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Chigusa
authors.initials: C
authors.lastname: Nakahashi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Oda
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Kazuto
authors.initials: K
authors.lastname: Inoue
authors.forename: Junji
authors.initials: J
authors.lastname: Furuse
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ochiai
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohkohchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis