A clinical review was performed to evaluate the sites of primary tumor, duration from primary resection to detection of liver metastasis, the relationship between serum CEA and liver metastasis, the sites of liver metastasis and survival period
in
56
patients with synchronous and metachronous liver metastasis, who were operated at Chonnam University Hospital from January 1988 to June 1992.
@ES The results
@EN 1) There were 596 gastric cancer, 236 colorectal cancer, 55 pancreatic cancers and 19 gall bladder cancers in 906 cases of cancer of gastrointestinal tract in this period.
2) There were 25 cases(2.8%) with synchronous liver metastasis demonstrated at the time of primary operation. The rate of liver metastasis at initial laparatomy was 20% in gastric cancer, 5.1% in colorectal cancer, 5.3% in gall bladder cancer.
3) There were 31 patients(3.4%) with metachronous liver metastasis during the follow-up period. The rate was 3.3% in gastric cancer, 3.8% in colorectal cancer and 3.6% in pancreas cancer.
4) The site of liver metastasis was 16 cases(28.6%) in right lobe, 11 cases(19.6%) in left lobe and 29 cases(51.8%) in both lobes.
5) The level of mean serum CEA with liver metastasis was 18.9ng/ml in gastric cancer, 506ng/ml in colorectal cancer 51.2ng/ml in pancreas cancer and 8.2ng/ml in gall bladder cancer. The positive rate of serum CEA above 5ng/ml was 50% in gastric
cancer,
80% in colo-rectal cancer, 50% in pancreas cancer and 100% in gall bladder cancer.
6) Several surgical approachs for synchronous liver metastasis were done in 11(44%) patients. We did 4 lobectomies, 4 wedge resection of liver, 3 catheterization of hepatic artery with port-a-cath(r) for regional chemotherapy.
7) The mean duration from primary operation to detection of detection of liver metastasis was 11.5 months(range 2 months).
8) Postoperative mean survival period for synchronous liver metastasis was 7 months, and 6.3 months in patients with metachronous liver metastasis.
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