title: Referral patterns of patients with liver metastases due to colorectal cancer for resection.
abstract: BACKGROUND
  Colorectal carcinoma accounts for 10% of cancer deaths in the Western World, with the liver being the most common site of distant metastases. Resection of liver metastases is the treatment of choice, with a 5-year survival rate of 35%. However, only 5-10% of patients are suitable for resection at presentation.
  
  
  OBJECTIVE
  To examine the referral pattern of patients with liver metastases to a specialist hepatic unit for resection.
  
  
  METHODS
  Retrospective review of patient's charts diagnosed with colorectal liver metastases over a 10-year period.
  
  
  RESULTS
  One hundred nine (38 women, 71 men) patients with liver metastases were included, mean age 61 years; 79 and 30 patients had synchronous and metachronus metastases, respectively. Ten criteria for referral were identified; the referral rate was 8.25%, with a resection rate of 0.9%. Forty two percent of the patients had palliative chemotherapy; 42% had symptomatic treatment.
  
  
  CONCLUSIONS
  This study highlights the advanced stage of colorectal cancer at presentation; in light of modern evidence-based, centre-oriented therapy of liver metastasis, we conclude that criteria of referral for resection should be based on the availability of treatment modalities.
authors.affiliation: Department of General Surgery, Our Lady of Lourdes Hospital, Drogheda, Co., Louth, Ireland. Usama_sahaf70@hotmail.com
authors.forename: O
authors.initials: O
authors.lastname: Al-Sahaf
authors.forename: Dhafir
authors.initials: D
authors.lastname: Al-Azawi
authors.forename: Ammar
authors.initials: A
authors.lastname: Al-Khudairy
authors.forename: Mohammad Z
authors.initials: MZ
authors.lastname: Fauzi
authors.forename: Sherif
authors.initials: S
authors.lastname: El-Masry
authors.forename: Peter
authors.initials: P
authors.lastname: Gilen
mesh_terms: D000328:Adult; D000367:Age Factors; 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; D010166:Palliative Care / Q000706:statistics & numerical data; D011379:Prognosis; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies