Detection of liver metastases in small-cell lung cancer: a comparison of peritoneoscopy with liver biopsy and ultrasonography with fine-needle aspiration.

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Abstract
Liver evaluation of 131 patients with small-cell lung cancer (SCLC) was performed both by peritoneoscopy (PS) with liver biopsy and by ultrasonography (US) with fine-needle aspiration. A total of 33 patients (25%) had liver involvement, 82% detected by US and 76% detected by PS. The difference was due to 27 incomplete investigations by PS and two incomplete investigations by US. In 104 patients in whom both investigations were "successful," PS confirmed 86% and US confirmed 79% of the patients with liver metastases. In each of the investigations, 7% (PS) and 14% (US) of patients had false-negative conclusions as compared with histologic evidence obtained by the other method. US found six patients with extrahepatic intraabdominal disease, while PS found none. S-lactic dehydrogenase (s-LDH), SGOT, and s-alkaline phosphatase were found to be too unspecific to indicate liver metastases unless all three tests were normal or abnormal. It is recommended that US should be used as the initial procedure when staging patients with SCLC, and that PS can be considered complementary in patients with negative US.