The prognostic value of preoperative alkaline phosphatase for resection of solitary liver metastasis from colorectal carcinoma.

A retrospective review was undertaken to determine the influence of preoperative alkaline phosphatase levels on the prognosis of patients who had undergone resection of liver metastasis from colorectal adenocarcinoma at Roswell Park Memorial Institute. From March 1967 to March 1985, 26 patients underwent laparotomy who were thought to have solitary liver metastasis. Twenty of these patients were divided into two groups: group A consisted of seven patients who survived at least 24 months without any evidence of disease and were free of disease at the time of this report. Group B consisted of 13 patients who recurred or died from metastases following liver resection. The preoperative levels of alkaline phosphatase clearly showed that an elevated level before surgery was associated with a poor prognosis in the majority of cases. In group A only one of seven patients had an elevated level where seven of 13 patients in group B had elevated preoperative alkaline phosphatase levels. In conclusion, preoperative alkaline phosphatase levels may be helpful in determining the prognosis of patients considered for curative resection of solitary liver metastasis from colorectal carcinoma.