Clinicopathological Analysis of Liver Metastasis from Colorectal Cancer

From 1976 through 1985, 404 patients with colorectal cancer underwent surgery in our department. Their background and clinicopathological findings were evaluated in relation to metachronous liver metastasis. In background, there were no significant differences between patients without liver metastasis and those with metachronous liver metastasis. Pathologically, neither patients with stage I nor those with Dukes' A had metachronous liver metastasis. The rate of vascular invasion was 87.5% in patients with synchronous liver metastasis (Group B), 16% in those with metachronous liver metastasis (Group A) and 8.8% in those without liver metastasis (Group C'). Lymph node metastasis was observed in 76% of Group A, 58.5% of Group B and 45.9% of Group C', patients. Lymph vessel invasion was observed in 53.8% of Group C', 80% of Group A and 85.4% of Group B patients. These results suggest that metachronous liver metastasis is closely related to lymph node metastasis and/or lymph vessel invasion as well as venous invasion. Careful follow up of the high risk group by way of carcinoembryonic antigen (CEA), computed tomography (CT) and ultrasonography may increase the chance of treatments such as hepatectomy or intra arterial infusion chemotherapy.