Clinical Study of Colo-rectal Cancer with Synchronous Liver Metastasis

Hiroo Oshita, Sengai Tanaka, Daizo Fukata

Department of surgery, Gifu City Hospital

In 64 cases of colorectal cancer with synchronous liver metastasis, we assessed clinical and pathological findings and long-time results by surgical technique. 1) Evaluation of the degree of liver metastasis showed that there were 27 cases of H₁, 11 cases of H₂, and 26 cases of H₃, right lobe metastasis accounted for 88.9% of the H₁ cases. In cancer of the left large intestine where blood flows into the inferior mesenteric vein, the cancer tended to be metastasized not only to the right lobe but also to the left lobe. 2) In cases where the primary lesion was resected, comparison of prognosis by the degree of liver metastasis by the degree of liver metastasis showed that H₃ had extremely bad prognosis. 3) Prognoses were compared among a group of H₁ with hepatectomy (Group A), a group of H₁ with colorectal resection (Group B), a group of H₂ with colorectal resection (Group C), a group of H₃ with colorectal resection (Group D), and a group without resection (Group E). The results indicated that Group A had a better post-operative short survival rate under a year than Group B. With comparison of Group B, C and D which underwent only resection of the primary lesion with Group E, extremely poor prognoses in Groups D and E were noted. 4) It was expected that at least in the H₁ cases, hepatectomy would produce an improvement in prognosis. However, primary lesion resection as reduction surgery in H₃ cases was not significant.

Key words
colo-rectal cancer with synchronous liver metastasis, stream line of portal flow, colo-rectal resection combined with hepatectomy, reduction surgery of colo-rectal cancer

Reprint requests
Hiroo Oshita Department of Surgery, Gifu City Hospital
7-1 Kashima-chou, Gifu, 500 JAPAN

Accepted
November 19, 1990

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