title: Prognostic factors and evaluation of surgical management of hepatic metastases from colorectal origin: a 10-year single-institute experience.
abstract: The aim of this study was to determine prognostic factors and outcome after liver resection for colorectal metastases in 102 patients over a period of 10 years. A stepwise procedure using proportional hazard regression analysis was used to identify prognostic factors. Estimated survival at 2 years was 71%, and at 5 years, 29% (Kaplan-Meier). Of 19 patients with isolated liver recurrence, 6 had a second metastasectomy; 4 of the 6 are still alive. We found that the number of hepatic lesions on computed tomography (P=0.012), the interval between resection of the primary colon tumor and the hepatic metastasectomy (P=0.012), and synchronicity of the primary and the hepatic metastasis (P=0.048) showed evidence of independent prognostic value regarding survival. Resection of hepatic colorectal metastases may result in long-term survival. Patients with recurrence after a first liver resection may benefit from a repeat metastasectomy. Our data suggest there is no strong predictor of survival. Survival seems to decrease with increasing number of metastases found on computed tomography.
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
authors.forename: Eduard L A R
authors.initials: EL
authors.lastname: Mutsaerts
authors.forename: Serge
authors.initials: S
authors.lastname: van Ruth
authors.forename: Frans A N
authors.initials: FA
authors.lastname: Zoetmulder
authors.forename: Emiel J T
authors.initials: EJ
authors.lastname: Rutgers
authors.forename: Augustinus A M
authors.initials: AA
authors.lastname: Hart
authors.forename: Frits
authors.initials: F
authors.lastname: van Coevorden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis