Alcoholic liver fibrosis is a relatively common form of alcoholic liver disease in Japan. It is regarded by some investigators as a prodromal stage of alcoholic liver cirrhosis, but little is known ...about the volumes of the liver and spleen in this disease state. Therefore, liver and spleen volumes were measured by computed tomography in 32 patients with alcoholic liver fibrosis in comparison with 10 healthy volunteers. Patients with alcoholic liver fibrosis were divided into three subgroups (13 of Grade 1, 9 of Grade 2 and 10 of Grade 3) according to the severity of fibrosis. The volume was calculated from the sum of the area measurements of successive transverse sections of the two organs. The liver volume (mean ± S.D.) in Grade 2 alcoholic liver fibrosis (1,281 ± 112 cm3) was significantly (p < 0.01) larger than in healthy volunteers (1,017 ± 73 cm3) and in Grade 1 (1,090 ± 157 cm3), and the liver volume in Grade 3 (1,490 ± 132 cm3) was larger than in Grade 2 (p < 0.01). The mean volume of hepatocytes estimated by a two‐dimensional image analysis system was significantly (p < 0.05) larger in Grade 3 than in Grade 2, and that in Grade 2 was larger than in Grade 1. The spleen volume in Grade 3 (151 ± 40 cm3) was significantly (p < 0.01) larger than in healthy volunteers (86 ± 26 cm3), Grade 1 (89 ± 38 cm3) and Grade 2 (68 ± 19 cm3). The presumed reason for hepatic volume increase would be the ballooning of hepatocytes along with increased fibrotic component.
A total of 107 patients with colorectal cancer underwent noncurative operations, including 17 relative noncurative resections, 80 absolute noncurative resections and 10 nonresections. There were 66 ...(62%) patients with a solitary noncurative factors and 41 (38%) with multiple noncurative factors. The 5-year survival rate was 10% for patients with a solitary noncurative factor and 0% for patients with multiple noncurative factors. The result difference was statistically significant. Among patients with a solitary noncurative factor, the 5-year survival rate was 15% for patients with peritoneal dissemination, 4% for patients with liver metastasis and 0% for patients with N4 lymphnode metastasis or invasion to an adjacent organ. These rates were not significantly different. Regarding the outcome according to the type of treatment, the 5-year survival rate was 29% for patients with relative noncurative resection and no patient with absolute noncurative resection or nonresection survived more than 5 years. There was a significant difference among these groups. Especially the 5-year survival rate for relative noncurative resection with P1 and H1 was good, 29% and 60% respectively. The 1-year survival rate was 53% for patients with absolute noncurative resection with multiple noncurative factors in which one of the factors was resected. This rate was better than that for absolute noncurative resection with multiple noncurative factors in which the factors were not resected, though the difference was not significant. These results suggest that resection of the primary lesions and noncurative factors improves the prognosis for patients with noncurative factors.
The significance of clinicopathological factors on the survival of 55 patients with liver recurrence after resection of colorectal cancer was studied by multivariate analysis using Cox's Proportional ...Hazards model. Disease free interval (DFI) and method of therapy for liver recurrence were the most influential factors on survival after resection of primary colorectal cancer and after detection of liver recurrence respectively. The prognosis of patients with DFI of more than 2 years was significantly better than that of patients with DFI of less than 2 years. Regarding the prognosis after detection of liver recurrence, survival rate for patients with liver resection was significantly higher than that for patients with other therapy except liver resection. The rate of liver resection was high in patients with a longer DFI. On the other hand serum CEA level was the most influential factor on DFI after resection of primary colorectal cancer and DFI of patients with serum CEA level of more than 10 ng/ml was significantly shorter than that of patients with serum CEA level of less than 10 ng/ml. These results suggest that the prognosis of patients with liver recurrence of colorectal cancer is strongly affected by the length of DFI after resection of the primary lesion.
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