## Most Common Site of Colorectal Cancer Metastasis **Key Point:** The liver is the most common site of distant metastasis in colorectal cancer, occurring in approximately 50–70% of patients with metastatic disease. ### Anatomical Basis - Colorectal venous drainage flows via the **portal vein** directly to the liver - Portal circulation delivers tumor cells preferentially to hepatic sinusoids - This explains the high frequency of hepatic metastases before systemic spread ### Frequency of Metastatic Sites in Colorectal Cancer | Site | Frequency (%) | |------|---------------| | Liver | 50–70 | | Lung | 10–20 | | Peritoneum | 5–10 | | Brain | <5 | | Bone | <5 | **Clinical Pearl:** Patients with isolated liver metastases may be candidates for hepatic resection, which can offer curative intent in select cases. **High-Yield:** When staging colorectal cancer, liver imaging (CT/MRI) is mandatory to detect metastases early.
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