LIVER-FUNCTION STUDIES IN THE ASSESSMENT OF HEAD AND NECK-CANCER PATIENTS

Background. Serum liver function tests (LFTs) are used in the initial evaluation of patients with head and neck squamous cell carcinoma (SCC ) to evaluate hepatic function and to screen for liver metastases. Met hods. One hundred forty patients initially seen with SCC between 1988 and 1991 were followed for a minimum of 2 years to determine the signi ficance of abnormal LFTs at presentation. Results. Abnormal values wer e found in 69 patients (49%), including elevated alkaline phosphatase in 37 (26%) and lactic dehydrogenase in 25 (18%). Abnormal values were most commonly attributed to alcohol-related liver disease. No liver m etastases were identified at initial screening. LFTs were normal at pr esentation in all three patients subsequently identified with liver me tastases during follow-up. Conclusions. Abnormal LFTs are commonly enc ountered but are of little value in identifying patients with liver me tastases during initial assessment. Modest elevation of LFTs should no t necessitate costly and time-consuming investigation to exclude hepat ic metastasis. (C) 1995 John Wiley & Sons, Inc.