Intra-abdominal extrahepatic disease in patients with colorectal hepatic metastases

Alan T. Lefor, Kevin S. Hughes, Eitan Shiloni, Seth M. Steinberg, John T. Vetto, Moshe Z. Papa, Paul H. Sugarbaker, Alfred E. Chang

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

The resection of hepatic metastases in patients with extrahepatic disease is of no proven benefit. Preoperative identification of extrahepatic disease may prevent unnecessary laparotomy. Preoperative evaluation including physical examination, computed tomography of the abdomen, full lung tomography or chest-computed tomography, and radionuclide bone scanning identified extrahepatic metastases, most commonly in the lung, in 25 of 132 patients with purported isolated liver metastases. Of 107 patients with negative staging evaluations, intra-abdominal extrahepatic metastases were found in 26 percent (28 of 107) at laparotomy, most commonly in portal and celiac lymph nodes. The presence of extrahepatic disease correlated with greater than 25 percent hepatic replacement by tumor, presence of symptoms, and Dukes' C primary lesions; however, none was predictive. We were unable to develop a model to preoperatively predict the presence of intra-abdominal extrahepatic disease. The authors recommend a preoperative evaluation including physical examination, and computed tomographic scans of the abdomen and chest. A bone scan is required only in patients with symptoms referable to bone. Despite a negative preoperative evaluation, however, a considerable proportion of patients with colorectal hepatic metastases will have extrahepatic disease at the time of abdominal exploration.

Original languageEnglish (US)
Pages (from-to)100-103
Number of pages4
JournalDiseases of the Colon & Rectum
Volume31
Issue number2
DOIs
StatePublished - Feb 1988
Externally publishedYes

Keywords

  • Extrahepatic metastases
  • Liver metastases

ASJC Scopus subject areas

  • Gastroenterology

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