Background: Liver metastases are frequent in pancreatic cancer, although their impact on patient mortality is still unclear.
Method: The extent of liver metastasis (H-III [diffuse], H-II [moderate], H-I [limited], H-0) and the magnitude of liver dysfunction (lf-III [failure], lf-II [severe], lf-I [moderate], lf-0) were reviewed in 89 locally advanced and resectable pancreatic cancer patients in order to determine possible relationships with mortality and survival.
Results: The extent of liver metastasis (H-III, 18; H-II, 20; H-I, 12; H-0, 39) and the magnitude of liver dysfunction (lf-III, 12; lf-II, 8; lf-I, 11; lf-0, 58) were quite variable. Based on the aforementioned two categories, pancreatic cancer patients could be divided into four groups: (A) extensive liver metastasis affecting patient mortality, 14% (12/89); (B) liver metastases that do not cause severe liver dysfunction, 38% (34/89); (C) severe liver dysfunction, not associated with liver metastasis, 9% (8/89); (D) spared liver function, with no liver metastasis, 39% (35/89). The median survival period of H-III patients (195 d) was quite short compared with those of H-I (288 d) and H-0 (240 d) patients.
Conclusion: Considering patients with locally advanced and resectable pancreatic cancer, the fraction of cases with diffuse liver metastases is relatively small. Moreover, only a minor proportion of pancreatic cancer patients die from hepatic failure as a direct result of liver metastasis.