[Incidence of isolated metastatic organ involvement in rectal cancer in an autopsy sample]

From the rectum carcinoma cases diagnosed and reported to the National Cancer Registry in 1980, 886 were submitted to obduction. Metastases were detected in 46.8% of the autopsy material. Affected were the liver in 38.7%, the lung in 16.1%, and the skeleton in 3.5% of the obducted cases. The pattern of metastases depended on the histological picture of the carcinoma: with adenocarcinomas, haematogenic metastases, and with mucigenic adenocarcinomas, lymphogenic metastases were predominant; the signet-ring-cell carcinomas develop their pronounced metastatic potency in either way. The isolated liver affection could be established in 9% of all liver metastatic patients who underwent radical operation, and in 22% following exclusion of a presacral recurrence, respectively. A histologically oriented scheme is proposed to complete the spreading diagnostics and to establish a therapeutic concept for liver metastases, and an additional, targeted, systematic intraperitoneal and endolymphatic application of cytostatic substances in the treatment of liver metastases to reduce the extrahepatic metastatic rate is discussed.