Incidence and morphology of liver metastasis from extrahepatic malignancies to cirrhotic livers.

Incidence and morphologic pattern of liver metastasis from extrahepatic cancer in cirrhosis were studied in 2162 consecutive autopsies performed during a 12.5 year period. The cirrhotic liver was less frequently affected by metastasis than the noncirrhotic liver (33.3% versus 46.4%). The incidence of extrahepatic malignancies and their hematogenous metastasis was lower (though statistically not significant) in patients with cirrhosis than in patients without cirrhosis (20% versus 32%). Patients with cirrhosis but without cancer died at a younger age (63.5 years) than patients with both cancer and cirrhosis (69.5 years). In cirrhotic livers, metastases from neuroendocrine tumors were predominantly localized within the parenchymal nodules, while nonendocrine carcinomas metastasized to the fibrotic septa. The results suggest (1) that patients with cirrhosis develop less frequently extrahepatic malignancies and hepatic metastasis than patients without cirrhosis, probably because of a shorter life expectancy due to the complications of liver cirrhosis; (2) microscopic localization of metastases in cirrhotic livers depend on tumor type.