Clinico-pathological features and survival of patients presenting with hepatic metastases: aretrospective analysis

Retrospective analysis of 135 patients who presented with liver metastases at the NCI-Free Cancer Clinic and the Aga Khan University Hospital, Karachi is presented. The mean age was 55 years and there was no significant sexual predilection. Commonly observed primary sites were gall bladder [13%], pancreas [11%], breast [10%], colorectum [8%] and lung [8%]. In 41 cases [30%], primary location remained undetermined. Most common histologic type was adenocarcinoma in both sexes. Majority [83%] had multiple metastases. Amongst those with solitary metastasis, 78% had right lobe involvement. Almost half of the patients presented with constitutional symptoms alone, while 31% had signs and symptoms related to hepatic involvement. Overall, the most commonly deranged laboratory tests were LDH [93%], albumin [84%], gamma glutamyl transferase [78%] and alkaline phosphatase [76%]. Chemotherapy was offered to most cases. Majority of patients expired, mostly due to hepatic failure. Median survival was 30 days and was shorter in those who presented with multiple metastases. These findings are compatible with previous reports and may assist in the management of these patients

Oncologic emergencies

Awareness of certain oncologic emergencies is absolutely essential in order to provide adequate care to the affected individuals and to minimize the morbidity and mortality from these disorders. This includes amongst others management of febrile immunocompromised patients, superior vena cava obstruction, spinal cord compression and some metabolic disorders like hyperuricemia, hypercalcemia, tumour lysis syndrome and lactic acidosis. The following text provides some of the basic information essential for the proper management of these disorders