One of the most important steps in the procedures of the surgeon on opening the abdomen of a patient with cancer is to inspect the liver with care, in order to determine possibly the presence or absence of metastatic cancer. The determination is one which may change completely the nature and degree of the contemplated operation. For example, some surgeons rigidly refuse to proceed with a gastrectomy, pancreatectomy, or rectal resection in the presence of hepatic metastases, regardless of their small size or small number, whereas other surgeons with different points of view would proceed with the resection and, even under favorable circumstances, practice metastasectomy. Moreover, an operation applied for obvious palliation is often of more limited scope than the radical procedures designed with hope for cure.
We thought it to be of interest to determine the accuracy of our diagnosis of freedom or noninvolvement of the liver by metastatic