ALCOHOL-CONSUMPTION ENHANCES LIVER METASTASIS IN COLORECTAL-CARCINOMAPATIENTS

BACKGROUND. It is important to identify risk factors for liver metasta sis in patients with colorectal carcinoma because the liver is the mos t common site of recurrence. Alcohol consumption reportedly is associa ted with hematogenous metastasis in certain animal models. Furthermore , some studies have shown that carmofur, a derivative of 5-fluorouraci l, is particularly effective as adjuvant chemotherapy for colorectal c arcinoma, and may even suppress liver metastasis, although the mechani sm by which this occurs remains unknown. In addition, carmofur is know n to inhibit alcohol metabolism. To the authors' knowledge, the relati on between liver metastasis in colorectal carcinoma and alcohol consum ption has not been examined previously. Therefore, the authors studied the relations between liver metastasis in colorectal carcinoma and va rious clinicopathologic factors including alcohol consumption status. METHODS. This study was comprised of 133 colorectal carcinoma patients with invasion beyond the submucosal layer who had undergone surgical resection. The subjects were examined and divided into two groups acco rding to the occurrence or absence of liver metastasis. The relations between liver metastasis and other clinicopathologic factors were anal yzed by univariate and multivariate statistical methods. RESULTS. Univ ariate analysis showed alcohol consumption (P = 0.0021) and blood vess el invasion (P = 0.0045) were correlated with liver metastasis. Multiv ariate analysis showed both to be independent risk factors for liver m etastasis. CONCLUSIONS. Alcohol consumption is an independent risk fac tor for liver metastasis in colorectal carcinoma patients. Therefore, patients with colorectal carcinoma who drink alcohol require intensive examination and follow-up with respect to liver metastasis. Further s tudy is necessary to confirm the effect of adjuvant chemotherapy using carmofur in colorectal carcinoma patients. Cancer 1998;83: 1483-8. (C ) 1998 American Cancer Society.