Risk factors for early extrahepatic metastasis in patients with liver metastasis from colorectal carcinoma.
OBJECTIVE
Hepatic resection is one of the most effective therapies for colorectal liver metastasis. However, extrahepatic metastasis is frequently encountered within a short time postoperatively. We attempted to clarify the risk factors for extrahepatic metastasis in patients with colorectal liver metastasis.


METHODS
We retrospectively analyzed data obtained from 116 consecutive patients with colorectal liver metastasis. To determine predictors of extrahepatic metastasis within 1 year of admission for treatment of colorectal liver, we examined 12 clinicopathologic factors by univariate and multivariate logistic regression analyses.


RESULTS
Eighty-five underwent hepatectomy and/or thermal ablation (hepatectomy group) and 31 underwent only chemotherapy (non-hepatectomy group). Thirty-one in the hepatectomy group and 19 in the non-hepatectomy group developed extrahepatic metastasis at 1 year after admission. Univariate analysis showed that treatment without hepatectomy and lymphatic vessel permeation at the primary site were significant predictive factors for extrahepatic metastasis within 1 year. Multivariate analysis showed lymphatic permeation of the primary tumor, and treatment without hepatectomy to be significantly related to the occurrence of extrahepatic metastasis within 1 year.


CONCLUSIONS
The two factors that we identified put patients with colorectal liver metastasis at high risk for extrahepatic metastasis. Systemic chemotherapy may be needed to prevent extrahepatic disease in such patients.
Sasaki
Atsushi
A
Department of Surgery I, Oita University Faculty of Medicine, Japan. sasakia@med.oita-u.ac.jp
Iwashita
Yukio
Y
Shibata
Kohei
K
Matsumoto
Toshifumi
T
Ohta
Masayuki
M
Inomata
Masafumi
M
Kitano
Seigo
S
D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016001:Confidence Intervals; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000473:pathology; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis