Liver function studies in the assessment of head and neck cancer patients.

Background: Serum liver function tests (LFTs) are used in the initial evaluation of patients with head and neck squamous cell carcinoma (SCC) to evaluate hepatic function and to screen for liver metastases.

Methods: One hundred forty patients initially seen with SCC between 1988 and 1991 were followed for a minimum of 2 years to determine the significance of abnormal LFTs at presentation.

Results: Abnormal values were found in 69 patients (49%), including elevated alkaline phosphatase in 37 (26%) and lactic dehydrogenase in 25 (18%). Abnormal values were most commonly attributed to alcohol-related liver disease. No liver metastases were identified at initial screening. LFTs were normal at presentation in all three patients subsequently identified with liver metastases during follow-up.

Conclusions: Abnormal LFTs are commonly encountered but are of little value in identifying patients with liver metastases during initial assessment. Modest elevation of LFTs should not necessitate costly and time-consuming investigation to exclude hepatic metastasis.