Elucidation of the Mechanism of Pulmonary Metastasis of Colorectal Cancer

Masao Kameyama, Ichiro Fukuda, Shingi Imaoka, Seizo Masutani, Hiroaki Ohigashi, Masahiro Hiratsuka, Yo Sasaki, Toshiyuki Kabuto, Osamu Ishikawa, Ken Kodama, Hiroshi Furukawa, Hiroki Koyama, Osamu Doi, Takeshi Iwanaga

Department of Surgery, The Center for Adult Diseases, Osaka

The time from the operation for colorectal cancer to the first detection of pulmonary metastasis was studied to elucidate the mechanism of the metastasis. Primary metastasis to the lung alone occurred in 41 patients who were employed as the subjects of this study. A disease free interval of 3 years or more was seen at a higher incidence for rectal cancer than for colon cancer (p<0.05). The tumor doubling time (TDT) was calculated for 21 pulmonary metastatic lesions. There was no difference in TDT or the major axis of the cancer between the colon cancer group and the rectal cancer group. During recent radical operations for rectal cancer, cytodiagnosis was performed on blood specimens collected from the inferior vena cava. In 2 (18%) of 11 cases, cytodiagnosis was negative for cancer cells before ligation of the inferior mesenteric artery and vein, but positive after ligation. Thus, it was found that pulmonary metastasis may be delayed in the case of rectal cancer compared with colon cancer, and this may be due to the surgical manipulation specific for rectal cancer.

Key words
pulmonany metastasis of colo-rectal cancer, disease free interval, tumor doubling time

Reprint requests
Masao Kameyama Department of Surgery, The Center for Adult Diseases, Osaka
1-3-3 Nakamichi, Higashinari-ku, Osaka, 537 JAPAN

Accepted
October 11, 1990

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