Less aggressive features of colorectal cancer with liver metastases showing macroscopic intrabiliary extension

We have previously reported the frequent occurrence of bile duct invasion by liver metastases from colorectal cancer. We found that patients with macroscopic intrabiliary cancer growth survive longer after hepatectomy than those without this feature. In the present study, we analyzed the clinicopath...

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Published in:Pathology international 2002-08, Vol.52 (8), p.514-518
Main Authors: Kubo, Makoto, Sakamoto, Michiie, Fukushima, Noriyoshi, Yachida, Shinichi, Nakanishi, Yukihiro, Shimoda, Tadakazu, Yamamoto, Junji, Moriya, Yoshihiro, Hirohashi, Setsuo
Format: Article
Language:English
Subjects:
Adenocarcinoma - pathology
Adenocarcinoma - secondary
Adult
Aged
Bile Duct Neoplasms - pathology
Bile Duct Neoplasms - secondary
colorectal cancer
Colorectal Neoplasms - pathology
Female
Hepatectomy
Humans
intrabiliary extension
liver metastasis
Liver Neoplasms - pathology
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Lymphatic Metastasis - pathology
Male
Middle Aged
Neoplasm Invasiveness
Retrospective Studies
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Summary:We have previously reported the frequent occurrence of bile duct invasion by liver metastases from colorectal cancer. We found that patients with macroscopic intrabiliary cancer growth survive longer after hepatectomy than those without this feature. In the present study, we analyzed the clinicopathological features of primary colorectal cancer showing macroscopic intrabiliary extension of liver metastases. We reviewed 217 patients who underwent initial hepatic resection for colorectal liver metastasis between 1992 and 1998, and analyzed the corresponding primary colorectal cancers clinicopathologically. Microscopic bile duct invasion was found in 89 of 217 cases (40.6%) and, of these cases, 23 (10.6%) had macroscopic intrabiliary extension. Histological sections of the corresponding primary colorectal cancer were available in eight (group A) of these 23 cases. These were compared with 20 cases, selected randomly, of colorectal cancer that did not show bile duct invasion and were diagnosed as liver metastases. These patients underwent hepatectomy during the same period as group A and were used as a control (group B). The histology of the primary tumors revealed well‐differentiated adenocarcinoma in 100% of group A and in 25% of group B. The average maximum diameter of the primary tumor was 5.32 cm in group A and 3.61 cm in group B. Venous invasion was detected in 25% of group A and in 90% of group B (P 
ISSN:1320-5463
1440-1827
DOI:10.1046/j.1440-1827.2002.01382.x