title: Fas/CD95 signaling rather than angiogenesis or proliferative activity is a useful prognostic factor in patients with resected liver metastases from colorectal cancer.
abstract: BACKGROUND
  The selection of resective therapy for colorectal hepatic metastases remains controversial. The aim of this study is to investigate the prognostic factors for patients with resected liver metastases from colorectal cancer by analyzing not only clinicopathological factors but also recent immunohistological markers.
  
  
  METHODS
  Eighty-five patients underwent hepatic resection for metastatic colorectal cancer over the past 20 years. Fas/CD95 expression, microvessel density, and proliferating cell nuclear antigen (PCNA) proliferative activity were assessed with immunohistochemical methods in addition to the clinicopathological factors. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards model, both univariately and multivariately.
  
  
  RESULTS
  Univariate and multivariate analyses revealed that the number of metastases, Fas/CD95 expression, and postoperative carcinoembryonic antigen doubling time (CEADT) were significant prognostic indicators, whereas the mode of hepatic resection, chemotherapy, and other clinicopathological factors had no influence on survival. Fas/CD95 index correlated with postoperative CEADT (p=0.039), number of metastases (p=0.018), and survival (p=0.023).
  
  
  CONCLUSIONS
  Our study confirmed the number of metastases and CEADT as prominent prognostic factors after hepatic resection for metastatic colorectal cancer. These two factors reflect the degree of Fas/CD95 signaling rather than angiogenesis or cancer growth rate.
authors.affiliation: Department of Surgery and Surgical Basic Science, Kyoto University, 54 Shogoin Kawara cho, Sakyo ku, Kyoto, 606-8507, Japan. onohisa@kuhp.kyoto-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Onodera
authors.forename: Akira
authors.initials: A
authors.lastname: Mori
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagayama
authors.forename: Akihisa
authors.initials: A
authors.lastname: Fujimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tachibana
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Yonenaga
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Tsuruyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D014408:Biomarkers, Tumor; D049109:Cell Proliferation; D015179:Colorectal Neoplasms / Q000098:blood supply / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D019014:fas Receptor / Q000235:genetics / Q000276:immunology / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D019014:fas Receptor