Kolorektal karsinomlarda karaciğer metastazlarının segmental dağılımının bilgisayarlı tomografi ile değerlendirilmesi

Öz

Giriş: Bu çalışmada kolorektal karsinomlar ile metastatik karaciğer lezyonlarının topografik dağılımı arasındaki ilişki araştırılmıştır. Gereç ve Yöntemler: Kolorektal kanseri ve metastatik karaciğer lezyonları olan hastalar bu çalışmanın hedef popülasyonunu oluşturdu. Demografik veriler, primer tümör lokalizasyonu, ve metastatik karaciğer lezyonlarının segmental dağılımına ilişkin veriler retrospektif olarak tarandı. Hasta dosyaları, endoskopi ve bilgisayarlı tomografi raporları gözden geçirildi. Ek olarak hastaların Couinaud klasifikasyonuna göre belirlenmiş olan metastatik karaciğer lezyonlarının segmental dağılım bilgileri tarandı. Bulgular: Doksan altı hastanın karaciğer metastazı yapmış kolorektal kanseri tanısı almış olduğu öğrenildi. Toplamda 251 metastatik karaciğer lezyonu saptandı. Bunların 169 (%67.3) tanesi sağ lobda, 80 (%31.9) tanesi ise sol lobda yer almaktaydı (p<0.0001). Couinaud klasifikasyonuna göre yapılmış olan değerlendirmede en sık etkilenmiş olanın segment VIII (%23.1), en nadir etkilenmiş olanın ise segment 1 (kaudat lob) öldüğü anlaşıldı. En sık tutulan karaciğer segmentleri sırasıyla segment VIII, V, VII, VI, III, II, IV, ve segment I`di. Primer tümörü sağ ve sol kolonda olan hastalar kıyaslandığında metastatik lezyonların segmental dağılımı açısından belirgin fark saptanmadı (p>0.05). Sonuç: Kolorektal kanserlerin karaciğer metastazları kolorektal tümörün lokalizasyonundan bağımsız olarak daha sağ lobda sol lobdan daha sıktır. Segment 8 en sık tutulan segmenttir.

Anahtar Kelimeler

• kolorektal karsinom
• karaciğer metastazı
• segmental dağılım
• Couinaud klasifikasyonu

Evaluation of segmental distribution of liver metastases in colorectal carcinomas by computed tomography

Abstract

Objective: We aimed to investigate the relationship between the localization of colorectal carcinomas and the topographic distribution of metastatic liver lesions. Material and Methods: Patients diagnosed with colorectal cancer and metastatic liver lesions constituted the target population of this study. Demographic data, primary tumor localization, and data regarding liver metastases were retrieved and retrospectively reviewed. Patient files, including endoscopy and computerized tomography reports, were the primary data source. In addition, data concerning segmental localization of the metastatic liver lesions based on the Couinaud classification were collected. Results: Ninety-six patients were diagnosed with colorectal cancer with liver metastases during the study period. A total of 251 metastases were detected. The number of metastases was 169 (67.3%) in the right and 80 (31.9%) in the left lobe (p<0.0001). Evaluation regarding Couinaud classification elucidated that the most frequently affected segment was segment VIII (23.1%), while segment 1 (i.e., caudate lobe) was the least commonly affected segment. The liver segments with the highest number of metastatic lesions were VIII, V, VII, VI, III, II, IV, and I, respectively. There was no significant difference in the segmental distribution of metastases in patients with primary tumors in the right and left colon (p>0.05). Conclusion: Liver metastases of colorectal cancer are significantly more common in the right lobe than the left lobe, irrespective of the location of the colorectal tumor. Segment VIII of the right lobe is the main target of the metastases.

Keywords

• colorectal carcinoma
• liver metastasis
• segmental distribution
• Couinaud classification

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