title: Importance of intra-individual variation in tumour volume of hepatic colorectal metastases.
abstract: OBJECTIVE
  The efficacy of surgical resection for multiple colorectal hepatic metastases (MCHM) has been controversial. We examined the survival of patients who received surgery for MCHM and examined the factors associated with survival.
  
  
  METHODS
  A retrospective analysis was performed of 50 consecutive patients who received hepatic resections for MCHM, defined as four or more metastatic lesions of colorectal cancer.
  
  
  RESULTS
  Overall survival after hepatic resection for MCHM was 48% at 3years and 43% at 5years (median survival, 22.3months). Multivariate analyses revealed that a coefficient of variation (CV) in volume of hepatic metastases in each individual patient above 1.8 (P=0.01, HR=4.08, 95% CI=1.33-12.5) was the only poor prognostic factor after resection of MCHM.
  
  
  CONCLUSIONS
  A CV in volume of hepatic metastases in each individual patient above 1.8 predicts poor survival after hepatectomy of MCHM. Thus, the CV in volume of hepatic metastases in each individual patient might be useful in planning the therapeutic strategy for patients with MCHM.
authors.affiliation: Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Chiba, Japan. shtakaha@east.ncc.go.jp
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Konishi
authors.forename: T
authors.initials: T
authors.lastname: Nakagohri
authors.forename: N
authors.initials: N
authors.lastname: Gotohda
authors.forename: T
authors.initials: T
authors.lastname: Hanaoka
authors.forename: N
authors.initials: N
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D015996:Survival Rate