title: Relationship between primary colorectal tumour and location of colorectal liver metastases.
abstract: BACKGROUND
  There is conflicting evidence regarding whether streamlining of blood flow within the portal vein influences the anatomical distribution of colorectal liver metastases (CRLM). This study assesses the relationship between primary tumour location and metastases location.
  
  
  METHODS
  Patients were identified using a prospectively maintained database, and those with known site of primary colorectal tumour and hemiliver involvement were included. Site of metastases and segments affected were confirmed via review of the radiology reports. The location of primary colonic tumour was confirmed via review of clinical correspondence letters.
  
  
  RESULTS
  A total of 2364 metastases were identified in 891 patients. Of these, 379 metastases were in the right lobe and 156 in the left lobe, with 356 having bilobar disease. There was no significant relationship between the distribution of CRLM and the site of primary disease (left colon versus right colon) (P = 0.819). However, when the segmental location of the metastases was considered, there is a statistically significant difference between the number of right-sided CRLM compared with left-sided CRLM (P < 0.001).
  
  
  CONCLUSIONS
  Right-sided CRLM is more likely regardless of the primary location. Portal streaming may have an effect, although the natural anatomical 'angulation', particularly of the left portal vein branch is more likely to play a role.
authors.affiliation: Department of HPB Surgery, St James's University Hospital, Leeds, West Yorkshire, UK.
authors.forename: Samir
authors.initials: S
authors.lastname: Pathak
authors.affiliation: Leeds Medical School, University of Leeds, Leeds, West Yorkshire, UK.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Palkhi
authors.affiliation: Department of HPB Surgery, St James's University Hospital, Leeds, West Yorkshire, UK.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Dave
authors.affiliation: Department of HPB Surgery, St James's University Hospital, Leeds, West Yorkshire, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: White
authors.affiliation: Department of HPB Surgery, St James's University Hospital, Leeds, West Yorkshire, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Pandanaboyana
authors.affiliation: Department of HPB Surgery, St James's University Hospital, Leeds, West Yorkshire, UK.
authors.forename: K Raj
authors.initials: KR
authors.lastname: Prasad
authors.affiliation: Department of HPB Surgery, St James's University Hospital, Leeds, West Yorkshire, UK.
authors.forename: J Peter A
authors.initials: JP
authors.lastname: Lodge
authors.affiliation: Department of HPB Surgery, St James's University Hospital, Leeds, West Yorkshire, UK.
authors.forename: Giles J
authors.initials: GJ
authors.lastname: Toogood
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011446:Prospective Studies
keywords: colorectal liver metastases; portal flow