NUMBER OF attempts to study liver function A in cancer patients with and without hepatic metastases have been made in the past, with a view to defining those derangements indicative of liver metastases. As recently as 1950, -4riel and Shahon concluded that none of the liver-function tests they studied could be utilized to demonstrate hepatic metastases. Other investigators have considered elevation of the serum alkaline phosphatase in the absence of bone disease to be an indication of liver metastases in the cancer patient.67 7, 159 2% 24 T h e bromsulfalein and other dye-excretion tests have been found to be more frequently abnormal in cancer patients with hepatic involvement than in those without extension of the tumor to the 12, 23, 30 It is generally held that the remaining tests commonly employed in the evaluation of liver function are not influenced significantly by liver metastases.
T h e pertinent clinical problem is the diagnosis of liver metastases at the time when radical curative cancer therapy is under consideration. Additional diagnostic aids are needed most for the patient with the fewest evidences of liver disease. It was accordingly believed of value to review the results of liverfunction tests in a large series of patients with hepatic metastases rand to correlate these results with the extent of metastatic involvement of the liver. Patients with gross jaundice or with involvement of the extrahepatic bile ducts were not considered in this study. Ninety-nine adults with liver metastases were analyzed, and a group of sixty-one cancer patients known to be free of gross extension to the liver were used as controls.
Methods
T h e tests reported were performed in the RIemorial Hospital laboratories. T h e follow-
From the Memorial Center for Cancer and Allied