[Hepatic lymph node involvement in patients with synchronous multiple liver metastases of colorectal cancer].
OBJECTIVE
Hepatic arterial infusion chemotherapy for unresectable liver metastases of colorectal cancer is generally indicated to patients without extra hepatic lesions. This study was performed to examine the status of hepatic lymph node metastasis as an extra hepatic lesion in patients with synchronous multiple liver metastases of colorectal cancer.


METHODS
A total of 111 hepatic lymph nodes were removed from 33 patients with synchronous liver metastases of colorectal cancer during resection of the primary tumor at the D2- or D3- level. The frequency of hepatic lymph node metastases and factors predictive for hepatic lymph node metastasis were examined.


RESULTS
Hepatic lymph node metastasis was detected in nine patients (27%): The sites were classified into three categories: (1) along the hepatic arteries in three, (2) in the hepato-duodenal ligament except the peri-hepatic arterial region in three, and (3) both in three. The serum level of CEA (p = 0.02), CA19-9 (p = 0.05), and the rate of lymph node metastasis of the primary lesion (p = 0.08) were higher or tended to be higher in patients with hepatic lymph node metastases than in those without. There was no significant relationship between the involvement of hepatic lymph nodes and the other clinicopathologic factors examined.


CONCLUSIONS
We should note the frequency of hepatic lymph node metastasis in the treatment of unresectable liver metastases of colorectal cancer.
Ishibashi
Keiichiro
K
Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
Ohsawa
Tomonori
T
Yokoyama
Masaru
M
Ishizuka
Naoki
N
Miyazaki
Tatsuya
T
Nakada
Hiroshi
H
Gonda
Tsuyoshi
T
Ishida
Hideyuki
H
D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000556:secondary*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000556:secondary*
D002272:Carcinoembryonic Antigen