Background/aims: Some studies have shown the reduction of portal blood flow in patients with occult hepatic metastases, which may lead to a decrease in the liver volume. The aim of this study was to assess volumetric changes of the liver with occult colorectal metastases.
Methodology: Sixty-three consecutive patients with colorectal cancer who underwent curative resection were studied retrospectively. The ratio of the preoperative computerized tomography (CT)-estimated liver volume to the standard liver volume (CV/SV ratio) was calculated as a uniform parameter to compare the volume between the liver with and without occult hepatic metastases.
Results: The CT-estimated liver volume was 841 +/- 102 (mean-SD) mL in 8 patients who subsequently developed overt hepatic metastases during a 2-year follow-up and 1145 +/- 232 mL in 55 patients without metastases (p = 0.0004). The CV/SV ratio was significantly smaller in patients with metachronous hepatic metastases than in those without (0.78 +/- 0.09 versus 1.02 +/- 0.14; p < 0.0001).
Conclusions: The results suggest the possibility that the liver with occult colorectal metastases decreases in size before metastatic tumors develop to be detectable with conventional imaging techniques. The measurement of the CV/SV ratio may be of value in detecting occult hepatic metastases from colorectal cancer.