title: Synchronous liver metastasis in colorectal cancer in Sri Lanka.
abstract: OBJECTIVE
  To assess the incidence of synchronous colorectal liver metastasis in patients referred to a tertiary referral center in Sri Lanka and to evaluate the differences in the clinicopathological features of patients with and without synchronous metastasis.
  
  
  METHODS
  Records of 438 patients were retrospectively analyzed. Patients were classified into metastatic group (n = 34, 8%) and non metastastatic group (n = 404, 92%). In the two groups macroscopic features compared were: tumor size (2 cm, 2-5 cm, and >5 cm), site of primary tumor and side of liver involved. Carcinoembryonic antigen (CEA) levels were recorded. At microscopy, tumor differentiation, invasion and nodal status were evaluated.
  
  
  RESULTS
  The rectum was the primary site of the tumor in a majority (60%) of patients. There was no difference in the distribution of the primary site and size of the tumor, pathological stage, lymphatic infiltration and the degree of tumor differentiation in two groups (p > 0.05). Patients with metastasis had higher levels of CEA, higher frequency of vascular infiltration and N3 nodes involved (p < 0.05).
  
  
  CONCLUSIONS
  The incidence of synchronous colorectal liver metastasis seems to be lower in our patients. Association of higher CEA level, advanced nodal stage and presence of vascular invasion needs to be further assessed with risk of developing metachronous liver metastasis.
authors.affiliation: Department of Surgery, University Surgical Unit, Kelaniya 10650, Sri Lanka. rohansiriwardana@yahoo.com
authors.forename: Rohan Chaminda
authors.initials: RC
authors.lastname: Siriwardana
authors.forename: S Ruwan E
authors.initials: SR
authors.lastname: Wijesuriya
authors.forename: Sumudu K
authors.initials: SK
authors.lastname: Kumarage
authors.forename: Kemal I
authors.initials: KI
authors.lastname: Deen
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013188:Sri Lanka / Q000453:epidemiology