Incidence Of Synchronous Liver Metastasis Research Articles

A retrospective case-series of influence of chronic hepatitis B on synchronous liver metastasis of colorectal cancer.

Our retrospective analysis of a large number of cases found in patients with primary colorectal cancer (CRC) carrying positive HBsAg inhibited the occurrence of synchronous liver metastases (SLM). However, liver cirrhosis caused by non-HBV factors promoted the occurrence of SLM. This study aimed to investigate the effect of HBV on the occurrence of synchronous liver metastases (SLM) of colorectal cancer (CRC). Univariate and multivariate analyses were used to analyze the influence of clinical parameters on the occurrence of SLM. A total of 6, 020 patients with primary CRC were included in our study, of which 449 patients carrying HBsAg(+) accounted for 7.46%. 44 cases of SLM occurred in the HBsAg(+) group, accounting for 9.80%, which was much lower than 13.6% (758/5571) in the HBsAg(-) group (X=5.214, P=0.022). Among CRC patients with HBsAg(-), the incidence of SLM was 24.9% and 14.9% in the group with high APRI and FIB-4 levels, respectively, which were significantly higher than that in the compared groups (12.3% and 12.5%, all P<0.05). Compared with the control group, female patients, late-onset patients, and HBV-infective patients had lower risks of SLM (HR=0.737, 95%CI: 0.614-0.883, P<0.001; HR=0.752, 95%CI: 0.603-0.943, P=0.013; HR=0.682, 95%CI: 0.473-0.961, P=0.034). The carriage of HBsAg(+) status inhibited the occurrence of SLM from CRC. HBV-causing liver cirrhosis did not further influence the occurrence of SLM, whereas non-HBV-factor cirrhosis promoted the occurrence of SLM. Nevertheless, this still required prospective data validation.

Oncological strategies for middle and low rectal cancer with synchronous liver metastases

Purposes: In rectal cancer, the incidence of synchronous liver metastases (SLM) ranges from 14% to 30%. The treatment of SLM combines neo-adjuvant chemo- and/or radiotherapy with of one three surgical resection strategies (rectal resection first, liver resection first or simultaneous resection). The present study evaluated the success rate for each resection strategy. MethodsFrom January 2005 to December 2013, we retrospectively included all patients with distal (middle and low) rectal cancer (MLRC) and SLM and who had been operated on with curative intent. The primary study endpoint was the proportion of complete resections at both tumour sites. The secondary endpoints were postoperative morbidity, the long-term outcome and risk factors for incomplete resection. Results52 patients were included. There were no significant intergroup differences in the incidence of complete resection (respectively 74%, 66% and 50% in the rectum-first (n = 20), simultaneous (n = 10) and liver-first groups (n = 5); p = 0.3), the overall complication rate or mortality rate after rectal resection (p = 0.5) or liver resection (p = 0.8), overall survival (60, 47 and 38 months, respectively; p = 0.4) or disease-free survival (31, 32 and 7.8 months, respectively; p = 0.1). Emergency surgery was the only risk factor for treatment failure (p = 0.01). ConclusionThere were no differences in short and long-term outcomes between the three strategies. No one oncological strategy should be favoured for all cases of MLRC with SLM. The strategy should be choosen, based on the oncological emergency (rectum-first or liver-first), predictive factors for morbidity in rectal surgery and MDT discussion.

The status of HBV infection influences metastatic pattern and survival in Chinese patients with pancreatic cancer

BackgroundIt has been proved that hepatitis B virus (HBV) infection alters the metastatic pattern and affects survival in colorectal cancer (CRC) and hepatocellular carcinoma (HCC), while the influence of HBV infection on metastatic pattern and survival in patients with pancreatic cancer (PC) has not been investigated yet.MethodsWe conducted an investigation to evaluate the impact of HBV infection on metastatic pattern and overall survival in PC. We collected the data of 460 PC patients treated in our hospital from 1999 to 2010. Serum HBV markers were tested with enzyme-linked immunosorbent assay. The impact of HBV infection on metastatic pattern and overall survival was analyzed.ResultsWe found that the incidence of synchronous liver metastasis was significantly higher in patients with HBsAg positive than those with HBsAg negative (46.0% vs 32.0%, P < 0.05), and higher in chronic HBV infection (CHB) group than both non HBV infection and resolved HBV infection group (61.1% vs 33.9%, P < 0.05, and 61.1% vs 28.7%, P < 0.05, respectively). What’s more, Kaplan-Meier analysis showed that CHB, resolved HBV infection and non HBV infection group had significant longer overall survival (OS) compared with inactive HBsAg carriers (IC) group (P=0.037, P=0.009, and P=0.019 respectively). But, in the multivariate analysis, only the CHB and non HBV infection group had significant better overall survival compared with IC group (P=0.010 and P=0.018 respectively).ConclusionsOur study found that HBV infection increased synchronous liver metastasis rate, and HBV infection status was an independent prognostic factor in PC patients.

Therapeutic strategies for synchronous and multiple liver metastases from colorectal cancer

Metastasis in the liver is one of the most critical factors in the prognosis of patients with colorectal cancer. The incidence of synchronous liver metastasis has been found to be approximately 20-25%, but the optimal timing of surgical resection remains controversial. Neoadjuvant chemotherapy has also been found to be beneficial not only for initially unresectable but also resectable synchronous metastases and traditional surgical strategies of hepatic resection with past chemotherapeutic regimens have been used less and less over the past several years. This review will discuss treatments in association with the recently developed chemotherapeutic regimens.

Therapeutic strategies for synchronous and multiple liver metastases from colorectal cancer.

Metastasis in the liver is one of the most critical factors in the prognosis of patients with colorectal cancer. The incidence of synchronous liver metastasis has been found to be approximately 20–25%, but the optimal timing of surgical resection remains controversial. Neoadjuvant chemotherapy has also been found to be beneficial not only for initially unresectable but also resectable synchronous metastases and traditional surgical strategies of hepatic resection with past chemotherapeutic regimens have been used less and less over the past several years. This review will discuss treatments in association with the recently developed chemotherapeutic regimens.

Strategies for Synchronous and Multiple Metastatic Liver Tumors Designed from Epithelial-Mesenchymal Transition Concept

At some point in the natural course of colorectal cancer up to 50% of patients will develop metastasis to the liver and it is one of the most critical effects for patient prognosis. The incidence of synchronous liver metastasis has been detected at around 20% - 25%, but the optimal timing of surgical resection remains controversial. Neoadjuvant chemotherapy has also been found to be beneficial not only for initially unresectable but also resectable synchronous metastases. Then, traditional surgical strategies of hepatic resection in accordance with past chemotherapeutic regimens have been used decreasingly over the past several years. This review will primarily discuss treatments in association with the recent developed chemotherapeutic regimens and surgical procedure from the clinical data and the concept for epithetlial-mesenchymal transition, which has recently been studied to elucidate mechanisms of the liver metastatic process.

Incidence of synchronous liver metastases in patients with colorectal cancer in relationship to clinico-pathologic characteristics. Results of a German prospective multicentre observational study

BackgroundThe aim of this prospective observational multicentre study was to evaluate the incidence of synchronous liver metastases in colon and rectal cancer and to determine clinico-pathologic factors of the colorectal cancer that influenced the development of synchronous liver metastases. MethodsOf 48,894 patients with colorectal cancer and who underwent surgery between January 2000 and December 2004, 7209 developed hepatic metastases and were analyzed. ResultsSynchronous liver metastases occurred in 14.7% of the colorectal cancer cases.Colon cancer (15.4%) led significantly more frequently to haematogenous spread to the liver than rectal cancer (13.5%) in a univariate approach. The N, V, and T stage, as well as the number of metastatic-involved local lymph nodes independently influenced the frequency of synchronous liver metastases in colon and rectal cancer in a multivariate analysis. Localization of the cancer in the colon led to a different number of synchronous liver metastases. Localization of the rectal cancer did not influence the rate of synchronous liver metastases. In the case of synchronous liver metastases, patients with colon cancer had significantly more peritoneal metastases (17.9 vs. 9.15%) but less lung (9.7 vs. 14%) and bone (0.7 vs. 1.6%) metastases. Simultaneous curative liver resections were done in 7% of colon cancer cases and in 8.8% of rectal cancer cases. ConclusionIn this national study the incidence of synchronous liver metastases in colon and rectal cancer were different. Independent factors leading to synchronous liver metastases could be identified. Venous infiltration seems to be important for the development of distant metastases.

Different incidence of synchronous liver metastasis between proximal and distal colon cancer

The clinicopathological features of colon cancer differ between proximal and distal sites; however, the influence of tumor location on liver metastasis has not been fully examined. The aim of this study was to evaluate the differences in the features of liver metastasis between proximal and distal colon cancer. The clinicopathological data from 931 colon cancer patients who were treated surgically were examined retrospectively using a multivariate analysis. The incidence of synchronous liver metastasis was 7.1% (31/438) in proximal colon patients and 11.6% (57/493) in distal colon patients. Both univariate and multivariate analyses showed distal colon cancer to be a risk factor for synchronous liver metastasis. The incidence of synchronous liver metastasis differs between proximal and distal colon cancer.

The immunohistochemical expression of BCL-2 oncoprotein in colorectal adenocarcinoma.

The immunoreactivity for bcl-2 oncoprotein was determined in tumor tissue samples from 40 patients with colorectal adenocarcinoma. Positive immunoreactivity for bcl-2 oncoprotein was seen in 14 of the 40 tumor tissue samples (35%) and was found to be associated with a significantly higher incidence of synchronous liver metastasis (P = 0.043); however, there was no correlation between the immunoreactivity for bcl-2 oncoprotein and tumor size, depth of tumor invasion, lymph node metastasis, or clinical stage of the disease. Among 33 patients who had undergone curative resection, disease-free survival did not differ significantly between 10 with bcl-2-positive tumors and 23 with bcl-2-negative tumors (P = 0.498). The present study showed that the positive immunohistochemical expression of bcl-2 oncoprotein was associated with a significantly higher incidence of liver metastasis from colorectal cancer, but it had no effect on the disease-free survival of patients who had undergone curative resection.

Survival following Surgical Treatment for Esophageal Cancer with Liver Metastases

An analysis of prospectively collected data was made on 490 patients with carcinoma of the esophagus seen between July 1982 and December 1986 to determine the incidence of synchronous liver metastases and the outcome of these patients. Twenty-seven patients (5.5%) had liver metastases detected by clinical examination, ultrasound scanning or at laparotomy. Fourteen patients had palliative resection of the tumor, 2 had a bypass, 7 had a laparotomy only and 4 were moribund. The median survival of resected patients was 4.5 months (range: 2–42 months) and for those with exploration alone it was 2.0 months (range: 0.5–7 months). The 2 patients who had a bypass lived 6 and 7 months, respectively. Patients undergoing exploration only had, in addition to liver metastases, unresectable primary tumors with peritoneal seedlings which precluded even a bypass. No statistically significant difference in survival can be demonstrated between this group of patients with liver metastases and those without liver involvement undergoing similar palliative treatment. We conclude that when relief of dysphagia is the primary goal of treatment, liver metastasis per se should not deter attempts at performing the most effective palliative procedure possible.

Natural history of patients with untreated liver metastases from colorectal cancer

One hundred fifty-five patients, laparotomized because of colorectal cancer, were retrospectively evaluated with special attention given to the natural course of untreated synchronous liver metastases. The median survival time for patients with synchronous liver metastases was 4.5 months. The survival time was mainly influenced by the extent of tumor involvement in the liver. Patients with elevated levels of serum-alkaline phosphatase at the time of operation had a significantly shorter survival time than those with normal values. Serum alkaline phosphatase levels are a good indication of prognosis. The incidence of synchronous liver metastases was 16 percent. This low rate is partly explained by the development of metachronous liver metastases in five patients within 1 year. Comparison with previous reports, often more than 10 years old, revels that the poor prognosis of patients with untreated liver metastases from colorectal cancer has remained unchanged.