Dr Haseeb ur Rehman, Dr Ahmad Hassan, Dr Malik Muhammad Toqeer
Objectives of the study: The main objective of the study is to find the risk factors affecting development of liver metastasis in rectal cancer patients. Methodology of the study: This descriptive study was conducted in Holy Family Hospital, Rawalpindi during March 2018 to October 2018. The data was collected from 50 patients through non-random sampling technique. All those patients who were suffering from colorectal cancer were included in this study. Patients with primary cancer in another organ were excluded. Lymph node involvement was divided into N0, N1 and N2. All stage Ⅲ and Ⅳ patients received neo-adjuvant chemotherapy. The neo-adjuvant chemotherapy will not be considered as a comparative factor in subsequent analyses, because it is strongly associated with tumor stages. According to the NCCN guideline, all CRC patients in stage II or more advanced CRC received a 5-Fu-based chemotherapy for at least 8 cycles postoperatively. Results: The data was collected from 50 patients. Only 10-20% of the patients with liver were aged below 50 years. On clinical staging, 2(7.7%) patients had stage II disease, 22(84.6%) had stage III, and 2(7.7%) patients had stage IV disease. Pre-op CEA levels were missing in 2(7.6%) cases, 15(57.6%) had normal and 9(34.6%) had raised serum CEA levels. All the 26(100%) patients received neo-adjuvant chemoX R T. On histopathology, 18(69%) patients had stage III disease. Specimen resection margins were negative for disease in 25(96%) patients. Post-op CEA levels were also missing in 2(7.6%) patients, while 12(46%) patients each had raised and normal CEA levels at 6-month follow-up. Conclusion: It is concluded that tumor depth, lymph node metastases, post-op serum CEA level s an d complete tumor response on histopathology can affect the development of metachronous liver lesions in patients having undergone curative surgical resection for rectal cancers.