title: Preoperative prognostic score for predicting survival after hepatic resection for colorectal liver metastases.
abstract: BACKGROUND
  Despite indications for resection of colorectal liver metastases having expanded, debate continues about identifying patients that may benefit from surgery.
  
  
  METHODS
  Clinicopathologic data from a total of 700 patients was gathered between January 1993 and January 2006 from a prospectively maintained dataset. Of these, 687 patients underwent resection for colorectal liver metastases.
  
  
  RESULTS
  The median age of patient was 64 years and 36.8% of patients had synchronous disease. The overall 5-year survival was 45%. The presence of an inflammatory response to tumor (IRT), defined by an elevated C-reactive protein (>10 mg/L) or a neutrophil/lymphocyte ratio of >5:1, was noted in 24.5% of cases. Only the number of metastases and the presence or absence of an IRT influenced both overall and disease-free survival on multivariable analysis. A preoperative prognostic score was derived: 0 = less than 8 metastases and absence of IRT; 1 = 8 or more metastases or IRT, and 2 = 8 or more metastases and IRT-from the results of the multivariable analysis. The 5-year survival of those scoring 0 was 49% compared with 34% for those scoring 1. None of the patients that scored 2 were alive at 5 years.
  
  
  CONCLUSIONS
  The preoperative prognostic score is a simple and effective system allowing preoperative stratification.
authors.affiliation: HPB and Transplant Unit, St. James's University Hospital, Leeds, UK.
authors.forename: Hassan Z
authors.initials: HZ
authors.lastname: Malik
authors.forename: K Rajendra
authors.initials: KR
authors.lastname: Prasad
authors.forename: Karim J
authors.initials: KJ
authors.lastname: Halazun
authors.forename: Amir
authors.initials: A
authors.lastname: Aldoori
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Mukhtar
authors.forename: Dhanwant
authors.initials: D
authors.lastname: Gomez
authors.forename: J Peter A
authors.initials: JP
authors.lastname: Lodge
authors.forename: Giles J
authors.initials: GJ
authors.lastname: Toogood
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein