A 62-year-old male who has had a right hemicolectomy for
colon cancer presents with malaise, weight loss, abdominal pain and distension
of the abdomen. On examination there is evidence of weight loss and the liver
is enlarged, hard in consistency and has a craggy edge and irregular surface.
In this patient which of the following features would
indicate a poor prognosis?
Elevated alkaline phosphatase
Malignant tissue on liver biopsy
Ultrasound evidence of metastases