Pyogenic liver abscesses associated with nonmetastatic colorectal cancers: an increasing problem in Eastern Asia.
OBJECTIVE
To elaborate the clinicopathologic features of colorectal cancer-related pyogenic liver abscess (PLA).


METHODS
Reported cases of colorectal cancer-related PLAs were collected from the literature published up to October 2011 and evaluated for their clinicopathologic features. Data of collected cases included demographics, clinical presentation, microbial ﬁndings and treatment. Categorical variables were compared by χ² analysis and continuous variables were evaluated using Student's t test.


RESULTS
A total 96 cases of colorectal cancer-related PLA were collected from the previous literature. Most patients (60%) were male and 40% cases occurred in the age group of 61-70 years. Apart from some special types of PLA, there were significant differences in the microbiological spectrum between Eastern Asia and non-Eastern Asian countries, which implied different risk factors and courses of the disease. Gram negative bacteria especially Klebsiella pneumoniae (K. pneumoniae) PLA was predominant in Eastern Asia (80.0%) in contrast to non-Eastern Asian countries (P < 0.01). Meanwhile, most of the Eastern Asian patients exhibited smaller size of liver abscess and atypical presentation. Sigmoid colon and rectum (72.73%) were the main sites of tumor in Eastern Asian patients, whereas tumor sites were uneven among most of the non-Easter Asian PLA patients.


CONCLUSIONS
K. pneumoniae PLA was strongly associated with colorectal cancer, especially those occurring in sigmoid colon and rectum, in elderly Eastern Asian male patients.
Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Kai
K
Qu
Chang
C
Liu
Zhi-Xin
ZX
Wang
Feng
F
Tian
Ji-Chao
JC
Wei
Ming-Hui
MH
Tai
Lei
L
Zhou
Fan-Di
FD
Meng
Rui-Tao
RT
Wang
Xin-Sen
XS
Xu
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000150:complications* / Q000473:pathology; D012809:Colon, Sigmoid / Q000473:pathology; D015179:Colorectal Neoplasms / Q000150:complications* / Q000473:pathology; D005202:Asia, Eastern; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae; D046290:Liver Abscess, Pyogenic / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000473:pathology
D000900:Anti-Bacterial Agents