What are the symptoms of rectal cancer liver metastasis

The liver is the main site of colorectal cancer metastasis, with an incidence rate of 50%. Colorectal cancer liver metastasis is a very complex biological process, the mechanism is not fully understood, and micrometastasis is one of the possible causes.

From an anatomical point of view, the venous blood that drains the colorectum flows into the portal vein and enters the liver. The hepatic sinusoid is the site of gastrointestinal blood return, with a high blood clearance rate, and is the organ where tumor cells are most likely to implant. Colorectal cancer is most likely to invade the vein. Once cancer cells fall off and enter the blood circulation, they can easily form metastatic lesions in the liver.

The liver is the most common organ of metastasis of malignant tumors. According to autopsy data from abroad: 40% of patients with malignant tumors have liver metastasis, and the liver metastasis rate of colorectal cancer patients is as high as 60 to 71%. Colorectal cancer liver metastasis is divided into synchronous liver metastasis and metachronous liver metastasis. The former refers to the discovery of liver metastasis at the same time as colorectal cancer, and the interval between the primary lesion and liver metastasis is less than 6 months; liver metastasis after colon cancer surgery, the interval between the primary lesion and liver metastasis is more than 6 months, which is metachronous liver metastasis. About 30 to 40% of metachronous liver metastasis occurs after so-called radical resection, and 80% occurs within 2 years after surgery. Liver metastasis is the main reason affecting the prognosis and long-term survival of colorectal cancer.

Pay attention to the problem of liver metastasis of colorectal cancer

For patients with colorectal cancer, doctors should consider the possibility of liver metastasis and perform liver ultrasound, CT and other related examinations before surgery. The liver should be routinely explored during surgery, and intraoperative ultrasound examination can be considered if necessary. Patients after treatment should be followed up every 3 to 6 months within 1 to 2 years after surgery; every 6 to 12 months within 3 to 5 years after surgery; and every 1 to 2 years after 5 years. Follow-up items include tumor marker (CA199, CEA) detection, ultrasound, CT and chest X-ray. Surgical patients should undergo regular colonoscopy to detect recurrence of the anastomosis and other parts of the colon. Measures to prevent liver metastasis of colorectal cancer: During surgery, the principle of no tumor should be observed; the operation should be performed gently to avoid squeezing the tumor; cloth tape can be used to tie the tumor margins on both sides; the intestine should be removed and lymph nodes should be cleared according to the principle of radical cure to achieve radical cure; intraoperative portal vein or hepatic artery catheterization can be used, and 5-FU continuous intravenous chemotherapy can be performed after surgery; a reasonable postoperative adjuvant treatment plan should be formulated based on the pathological results and close follow-up should be performed.