A Chronological Study of Hepatic Metastasis from Colorectal Cancer

Sakae Miyamoto

The First Department of Surgery, The Jikei University School of Medicine

An almost equal and parallel correlation was noted between CEA doubling time and tumor (volume) doubling time among patients with hepatic metastasis from colorectal cancer. Based on these facts, a chronological study was made of 30 cases of hepatic metastasis from colorectal cancer, with the following results. (1) When the patients were left totally or virtually untreated, the metastatic tumor cells (MTC) doubled an average of 41.5 times. (2) MTC in the liver were believed to have started proliferation an average of 4 years and 7 months before surgical resection of the primary lesion. (3) MTC had presumably doubled an average of 32.6 times by the time the serum CEA level began to rise exponentially. (4) When a definite image diagnosis of hepatic metastasis could be made, MTC should have doubled an average of 35 times, and the metastatic tumor attained a diameter of 3.2 cm. (5) It is considered that in patients with hepatic metastasis the tumor has already gone through nearly three-fourths of its natural course (from the onset of the seeded hepatic tumor growth to the patient's death), before clinical manifestation of liver metastasis. Cognizance of these chronological features, therefore, is of great importance for the diagnosis and treatment of hepatic metastasis from colorectal cancer.

Key words
hepatic metastasis from colorectal cancer, tumor doubling time, CEA doubling time, chronology

Reprint requests
Sakae Miyamoto First Department of Surgery, The Jikei University School of Medicine
3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105 JAPAN

Accepted
February 13, 1991

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