title: Estimation of the time of pulmonary metastasis in colorectal cancer patients with isolated synchronous liver metastasis.
abstract: OBJECTIVE
  The aim of this study was to estimate the time when pulmonary metastases began to grow in colorectal cancer (CRC) patients with isolated synchronous liver metastasis based on the tumor doubling time (DT).
  
  
  METHODS
  We examined 23 pulmonary metastases in 14 patients detected after resection of liver metastases from CRC (group 1) and 19 pulmonary metastases in eight patients detected after initiation of hepatic arterial infusion chemotherapy for synchronous unresectable liver metastases (group 2). The regression line was determined from the chest X-ray films, and the DT was calculated.
  
  
  RESULTS
  We estimated the DTs of pulmonary metastases as 65.0 +/- 28.9 and 76.2 +/- 23.0 days in groups 1 and 2, respectively, and the time when pulmonary metastases began to grow as 16-1418 and 112-1464 days before the resection of liver metastases for 19 lesions in 12 out of 14 patients of group 1 and before resection of primary CRC in group 2, respectively.
  
  
  CONCLUSIONS
  It appears that in some CRC patients in whom the metastatic site is considered to be limited to the liver at diagnosis, occult pulmonary metastasis has already taken place.
authors.affiliation: Department of Surgery, Tokai University, Bohseidai Isehara, Kanagawa 259-1193, Japan. sadahiro@is.icc.u-tokai.ac.jp
authors.forename: Sotaro
authors.initials: S
authors.lastname: Sadahiro
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishizu
authors.forename: Seiei
authors.initials: S
authors.lastname: Yasuda
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
authors.forename: Chieko
authors.initials: C
authors.lastname: Murayama
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D002455:Cell Division / Q000502:physiology; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary*; D009378:Neoplasms, Multiple Primary; D012189:Retrospective Studies; D013995:Time
chemical_list: D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil