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Japanese Journal of Clinical Oncology 2005 35(1):18-22; doi:10.1093/jjco/hyi010
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© 2005 Foundation for Promotion of Cancer Research

Estimation of the Time of Pulmonary Metastasis in Colorectal Cancer Patients with Isolated Synchronous Liver Metastasis

Sotaro Sadahiro1, Toshiyuki Suzuki1, Kenji Ishikawa1, Tomoki Nakamura1, Yoichi Tanaka1, Kazuhiro Ishizu1, Seiei Yasuda1, Hiroyasu Makuuchi1 and Chieko Murayama2

1 Department of Surgery and 2 Radiology, Tokai University, School of Medicine, Isehara, Kanagawa, Japan

For reprints and all correspondence: Sotaro Sadahiro, Department of Surgery, Tokai University, Bohseidai Isehara, Kanagawa 259-1193, Japan. E-mail: sadahiro{at}is.icc.u-tokai.ac.jp

Received September 5, 2004; accepted November 20, 2004

Objective: The aim of this study was to estimate the time when pulmonary metastases began to grow in colorectal cancer (CRC) patients with isolated synchronous liver metastasis based on the tumor doubling time (DT).

Methods: We examined 23 pulmonary metastases in 14 patients detected after resection of liver metastases from CRC (group 1) and 19 pulmonary metastases in eight patients detected after initiation of hepatic arterial infusion chemotherapy for synchronous unresectable liver metastases (group 2). The regression line was determined from the chest X-ray films, and the DT was calculated.

Results: We estimated the DTs of pulmonary metastases as 65.0 ± 28.9 and 76.2 ± 23.0 days in groups 1 and 2, respectively, and the time when pulmonary metastases began to grow as 16–1418 and 112–1464 days before the resection of liver metastases for 19 lesions in 12 out of 14 patients of group 1 and before resection of primary CRC in group 2, respectively.

Conclusion: It appears that in some CRC patients in whom the metastatic site is considered to be limited to the liver at diagnosis, occult pulmonary metastasis has already taken place.

Key Words: colorectal cancer • liver metastasis • pulmonary metastasis • tumor doubling time


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