The value of clinical assessment for preoperative prediction of liver metastases in suspected gastrointestinal cancer. A prospective, consecutive study

Surgeons' ability to predict liver metastases preoperatively was studied in 185 operable, nonicteric patients strongly suspected to have gastrointestinal cancer. The prediction was based on a clinical assessment comprising medical history, physical examination and low-cost laboratory tests. A p...

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Bibliographic Details
Published inActa chirurgica Scandinavica Vol. 152; p. 35
Main Authors Christensen, M, Rickers, H, Jacobsen, P M
Format Journal Article
LanguageEnglish
Published Sweden 01.01.1986
Subjects
Adult
Aged
Alkaline Phosphatase - blood
Clinical Enzyme Tests
Gastrointestinal Neoplasms - surgery
Humans
Liver Neoplasms - diagnosis
Liver Neoplasms - secondary
Middle Aged
Prospective Studies
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Summary:Surgeons' ability to predict liver metastases preoperatively was studied in 185 operable, nonicteric patients strongly suspected to have gastrointestinal cancer. The prediction was based on a clinical assessment comprising medical history, physical examination and low-cost laboratory tests. A pathoanatomic verification procedure was used. The observed predictive value of a positive test was 0.67 and there was a false-negative ratio of 0.79. At the clinical assessment, presence of metastases was believed to be more common in gastric than in colorectal disease (6/43 vs. 3/142), but the actual incidence of metastases was similar in the two groups. Serum alkaline phosphatase (AP) was a priori believed to be of value in the clinical assessment. But the clinical assessment with inclusion of AP was inferior to AP alone as a predictor of metastases, due to undervaluation of the importance of elevated AP in cases of colorectal disease. The difficulties in standardization of the clinical assessment are underlined.
ISSN:0001-5482