Colorectal cancer in Auckland 1981-1982: patients with liver metastases.

In a population-based study of 402 cases of colorectal cancer in Auckland, 72 patients (18%) demonstrated liver metastases either at presentation or at initial surgery. The findings of pre-operative weight loss, hepatomegaly and elevated alkaline phosphatase were significantly associated with heptic metastases. Individually these factors were insensitive indicators of the presence of liver metastases. Two or more of these risk factors were demonstrated by 54% of the patients with liver secondaries compared to 19% in the series without liver metastases. Continuing surveillance of the latter group of patients will show whether they are also at risk of developing liver secondaries. The median survival for the 69 patients who were diagnosed before death was 6.0 months. When the primary lesion was resected and the patient survived the post-operative period the median survival was 11.0 months.

Age and sex differences in right colon cancer.

In a prospective study of 402 colorectal cancer patients, 133 patients (46 men and 87 women) presented with right colon cancer. There was no significant difference between men and women in right colon cancer incidence. Common presenting features were abdominal pain, weight loss, and anemia. Ninety-one patients underwent resection with curative intent. There were significantly fewer Dukes' A tumors in the right colon cancer series (P less than 0.05). Significantly more women in the right colon cancer group were over 70 years old (P less than 0.05). The findings of peritoneal metastases and poorly differentiated lesions at initial surgery also were associated significantly with women who had right colon cancer (P less than 0.05). This study confirms previous reports of more advanced tumors in the right colon. The need for age, sex, and subsite differences to be taken into account when assessing treatment outcomes or survival is emphasized.

Influence of height, weight, and obesity on breast cancer incidence and recurrence in Auckland, New Zealand.

The relationship between obesity and breast cancer has been investigated in 1281 Auckland breast cancer patients. Using a definition of obesity as a Body Mass Index (BMI) of greater than or equal to 28 kg/m2, 179 (14%) breast cancer patients were classified as obese. The heights, weights, and BMI of 822 breast cancer patients aged 35-64 compared to 518 randomly selected Auckland women of similar age showed no significant difference. Within the breast cancer patients, there was no variation in nodal status or estrogen and progesterone receptor status between obese and non-obese women. However, tumours greater than 5 cm occurred significantly more often in obese patients. Time to recurrence was reduced in obese women with tumours less than or equal to 5 cm, no tumour in the axillary nodes, positive estrogen or progesterone receptor, and without metastases at the time of presentation of the disease. Although obesity has not been shown to influence breast cancer incidence, an effect on tumour recurrence is seen in patients with less advanced disease. This is similar to other reports which suggest that obesity is a weak but positive risk factor for recurrence.