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Journal of the Korean Society of Coloproctology 2004;20(4):211-217.
Clinicopathologic Features of Colorectal Cancer with Liver Metastases.
Choi, Sun Keun , Jeon, Yong Sun , Bae, Sun Young , Kwak, Min Keun , Hur, Yoon Seok , Lee, Keon Young , Kim, Sei Joong , Cho, Young Up , Ahn, Seung Ik , Hong, Kee Chun , Shin, Seok Hwan , Kim, Kyung Rae , Woo, Ze Hong
1Departments of Surgery, Inha University College of Medicine, Korea. woopark@inha.ac.kr
2Departments of Radiology, Inha University College of Medicine, Korea.
3Songdo Colorectal Hospital, Korea.
4Seoul Anorectal Clinic, Korea.
Abstract
PURPOSE
The aim of this study was to clarify the clinicopathologic features in colorectal cancer with liver metastases and to evaluate their clinical significance.
METHODS
From August 1996 to April 2002, 545 patients, who underwent radical surgery for primary colorectal cancers, were analyzed retrospectively.
RESULTS
Colorectal cancers with and without synchronous liver metastases at the time of the surgery were 36 and 509 cases, respectively. Of the 509 cases without metastases, 34 cases had metachronous liver metastases by April 2002, but the others did not. Serosal, vascular, perineural, and lymph node invasions, as well as increased preoperative CEA levels, were more frequently observed in those with synchronous liver metastases than it was in those without metastases (P<0.05). According to multivariate analyses, lymph node invasion was statistically significant as an independent variable in those with synchronous metastases (P=0.009). Serosal, vascular, and lymph node invasions, increased preoperative CEA levels, DNA ploidy, and positive lateral resection margins were more frequently observed in those with metachronous liver metastases than it was in those without metastases (P<0.05). According to multivariate analyses, vascular invasion was statistically significant in those with metachronous metastases (P=0.015).
CONCLUSIONS
Lymph node and vascular invasions appear to be significant determinants for synchronous and metachronous liver metastases in colorectal cancers. Therefore, close observation and careful postoperative follow-up is needed for such patients.
Key Words: Colorectal cancer; Liver metastases; Vascular invasion; Lymph node invasion


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