Fatma TERZİOĞLU ŞAHİN, Yasin Furkan ÇAĞIN

Etiological findings in cases with incidental liver metastasis and factors affecting survival

Aim: In this study, the general characteristics of incidental liver metastasis and the factors affecting survival were investigated. Materials and Methods: In our study, we retrospectively analyzed 216 patients with metastases in the liver at diagnosis. Patients with previously known primary malignancy and liver failure due to chronic viral hepatitis were excluded from the study. Results: The etiological causes of metastatic liver lesions were cancer of unknown primary (CUP) 27.78%, pancreato biliary region tumors ( PBRT) 19.44%, colorectal cancer (CRC) 18.98% and 12.96% gastric cancer, in order of frequency. No significant correlation was found in the concordance analysis between CT and USG in detecting metastases In the survival analysis, higher alanine aminotransferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), gamma-glutamyl transpeptidase (GGT), cancer antigen 19- 9 (CA 19-9), total bilirubin (TBIL), direct bilirubin (DBIL) levels and lower albumin levels were found to be statistically significant in patients who died compared to aliving patients (p

PDF

___

References 1. Abbruzzese JL, Abbruzzese MC, Lenzi R, et al. Analysis of a diagnostic strategy for patients with suspected tumors of unknown origin. J Clin Oncol 1995, 13: 2094–2103.
2. Risio D, Percario R, Legnini M, et al. Diffuse large B-cell lymphoma of the colon with synchronous liver metastasis[202F?]: a rare case report mimicking metastatic colorectal adenocarcinoma. 2014, 14: 1–5.
3. Swaid F, Downs D, Rosemurgy AS. A practical approach to liver metastasis from unknown primary cancer[202F?]: What surgeons need to know. Cancer Genet 2016, 209: 559–566.
4. Parkin DM, Bray F, Ferlay J, et al. Global Cancer Statistics, 2002. CA Cancer J Clin 2005, 55: 74–108.
5. Adam R, Chiche L, Aloia T, et al. Hepatic Resection for Noncolorectal Nonendocrine Liver Metastases Analysis of 1452 Patients and Development of a Prognostic Model. Ann Surg.,244. Epub ahead of print 2006.
6. Petrakis D, Pentheroudakis G, Voulgaris E, et al. Prognostication in cancer of unknown primary (CUP): Development of a prognostic algorithm in 311 cases and review of the literature. Cancer Treatment Reviews 2013, 39: 701–708.
7. Hogan BA, Thornton FJ, Brannigan M, et al. Hepatic metastases from an unknown primary neoplasm (UPN): survival, prognostic indicators and value of extensive investigations. Clin Radiol 2002, 57: 1073–7.
8. Pavlidis N, Khaled H, Gaafar R. A mini review on cancer of unknown primary site: A clinical puzzle for the oncologists. Journal of Advanced Research. Epub ahead of print 2015.
9. Funaki B, Guest Editors MD, Ray CE, et al. Epidemiology of Primary and Secondar yLiver Cancers. 2006.
10. Conner JR, Hornick JL. Metastatic carcinoma of unknown primary: Diagnostic approach using immunohistochemistry. Advances in Anatomic Pathology, 22. Epub ahead of print 2015.
11. Dietrich CF, Kratzer W, Strobel D, et al. Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI. World J Gastroenterol 2006, 12: 1699–1706.
12. Robinson PJ. The early detection of liver metastases. Cancer Imaging 2002, 2: 1–3.
13. Kadiyoran C, Cizmecioglu HA, Cure E, et al. Liver metastasis in colorectal cancer :Evaluation of segmental distribution. Prz Gastroenterol 2019, 14: 188–192.
14. Mazzaferro V, Pulvirenti A, Coppa J. Neuroendocrine tumors metastatic to the liver: How to select patients for liver transplantation? Journal of Hepatology 2007, 47: 460–466.
15. Stephens MR, Hopper AN, White SR, et al. Colonoscopy first for iron-deficiency anaemia: A Numbers Needed to Investigate approach. QJM 2006, 99: 389–395.
16. Sasaki A, Kawano K, Inomata M, et al. Value of serum carbohydrate antigen 19-9 fo rpredicting extrahepatic metastasis in patients with liver metastasis from colorecta lcarcinoma. Hepatogastroenterology , 52: 1814–9.
17. Wu XZ, Ma F, Wang XL. Serological diagnostic factors for liver metastasis in patients with colorectal cancer. World J Gastroenterol 2010, 16: 4084–4088.
18. Dong H, Tang J, Li L-H, et al. Serum carbohydrate antigen 19-9 as an indicator of liver metastasis in colorectal carcinoma cases. Asian Pac J Cancer Prev 2013, 14: 909–13.
19. Griscom JT, Wolf PS. Cancer, Liver Metastasis. StatPearls Publishing ,http://www.ncbi.nlm.nih.gov/pubmed/31971757 ( 2020, accessed 12 April 2020).
20. Clark ME, Smith RR. Liver-directed therapies in metastatic colorectal cancer. Journal of Gastrointestinal Oncology 2014, 5: 374–387.
21. Cao R, Wang L-P. Serological Diagnosis of Liver Metastasis in Patients with Breas tCancer. Cancer Biol Med , 9. Epub ahead of print 2012.
22. Tsai HJ, Hsieh MY, Tsai YC, et al. Liver function tests may be useful tools for advanced cancer patient care: A preliminary single-center result. Kaohsiung J Med Sci 2014, 30: 146–152.
23. Gürağaç A, Demirer Z. The neutrophil-to-lymphocyte ratio in clinical practice. Journal of the Canadian Urological Association 2016, 10: 141.
24. Jung HI, Ahn T, Kang DH, et al. Elevation of Preoperative neutrophil-lymphocyte ratio (NLR) and CEA is associated with poor prognosis in patients with synchronous colorectal cancer with liver metastasis. Eur J Surg Oncol 2019, 45: e111–e112.
25. Zhu Y, Yang Y, Wang Y, et al. Original Article Role of serum CA125 and CA199 concentration in diagnosis and prognosis evaluation of lung cancer patients, www.ijcep.com/ (2016, accessed 19 February 2020).
26. Zhou S, Wang Z, Li M, et al. Elevated Preoperative Serum CA125 Predicts Larger Tumor Diameter in Patients with Hepatocellular Carcinoma and Low AFP Levels. Biomed Res Int , 2019. Epub ahead of print 2019.
27. Nishida K, Kaneko T, Yoneda M, et al. Doubling time of serum CA 19-9 in the clinical course of patients with pancreatic cancer and its significant association with prognosis. J Surg Oncol 1999, 71: 140–146.
28. Pavlidis, Nicholas, et al. "Evaluation of six tumor markers in patients with carcinoma of unknown primary." Medical and pediatric oncology 22.3 (1994): 162-167.
29. Mattar R, Alves de Andrade CR, DiFavero GM, et al. Preoperative serum levels of CA 72-4, CEA, CA 19-9, and alphafetoprotein in patients with gastric cancer. Rev Hosp Clin Fac Med Sao Paulo 2002, 57: 89–92.
30. Vazquez Martinez MA, Correa E, Jeurkar C, et al. The prognostic significance of PSA as an indicator of age standardized relative survival: An analysis of the SEER databas e2004-2014. J Clin Oncol 2018, 36: e18768–e18768.
31. Wang SC, McCarthy LP, Mehdi S. Isolated Hepatic Metastasis from Prostate Carcinoma. Urol Case Reports 2017, 10: 51.