title: Metachronous liver metastases and resectability: Fong's score and laparoscopic evaluation.
abstract: OBJECTIVE
  The aim of this retrospective study was to establish whether Fong's risk score can predict rate of resectability and whether laparoscopic exploration with ultrasonography can reduce the number of useless laparotomies to any extent.
  
  
  METHODS
  Fong's score was calculated for each of the 43 potential resectable patients. We analysed: the relation between score and resectability; the probability of unnecessary laparotomy with respect to each level of score; and which of the five Fong parameters was the most indicative of non-resectability. None of our patients was submitted to preoperative laparoscopic staging.
  
  
  RESULTS
  All patients with Fong's score 0 were submitted to liver resection, whereas only 76.9% with score 1, 58.3% with score 2, and 66.6% with score 3. No patients had score 4 and 5. "CEA level" is the parameter that best predicts the "non-resectability" of metastases. In the subgroup with score 0-1, laparoscopy would have spared 12% of unnecessary laparotomies, whereas in subgroup 2-3 this percentage would have risen to 38.9.
  
  
  CONCLUSIONS
  The above data allowed us to quantify statistically the risk associated with non-resectability of liver metastases in a directly proportional manner as the score progresses.
authors.affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Catania, Italy. g.lidestri@unict.it
authors.forename: G
authors.initials: G
authors.lastname: Li Destri
authors.forename: F
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: B
authors.initials: B
authors.lastname: Torrisi
authors.forename: T R
authors.initials: TR
authors.lastname: Portale
authors.forename: F
authors.initials: F
authors.lastname: Mosca
authors.forename: R
authors.initials: R
authors.lastname: Vecchio
authors.forename: A
authors.initials: A
authors.lastname: Di Cataldo
authors.forename: S
authors.initials: S
authors.lastname: Puleo
references.citation: Br J Surg. 2004 Oct;91(10):1361-9
references.pmid: 15376205
references.citation: Arch Surg. 2003 Jul;138(7):770-2
references.pmid: 12860759
references.citation: Cancer. 2001 Mar 15;91(6):1121-8
references.pmid: 11267957
references.citation: Ann Surg. 2005 May;241(5):715-22, discussion 722-4
references.pmid: 15849507
references.citation: Ann Surg. 1999 Sep;230(3):309-18; discussion 318-21
references.pmid: 10493478
references.citation: Eur J Surg Oncol. 2007 Oct;33(8):1010-3
references.pmid: 17267165
references.citation: Ann Surg. 2007 Aug;246(2):183-91
references.pmid: 17667495
references.citation: Radiology. 2005 Oct;237(1):170-80
references.pmid: 16126930
references.citation: Arch Surg. 2005 Aug;140(8):727-34
references.pmid: 16103281
references.citation: ANZ J Surg. 2004 Dec;74(12):1056-9
references.pmid: 15574147
references.citation: Surg Oncol. 2006 Jul;15(1):1-12
references.pmid: 16891116
references.citation: Ann Surg. 2007 Aug;246(2):295-300
references.pmid: 17667509
references.citation: Br J Surg. 2005 Mar;92(3):362-9
references.pmid: 15672427
references.citation: J Gastrointest Surg. 2005 Mar;9(3):374-80
references.pmid: 15749600
references.citation: J Gastrointest Surg. 2006 Jan;10(1):86-94
references.pmid: 16368496
references.citation: Arch Surg. 2004 Dec;139(12):1326-30
references.pmid: 15611458
references.citation: Cancer Imaging. 2005 Nov 23;5 Spec No A:S149-56
references.pmid: 16361131
references.citation: Chirurg. 2005 Jun;76(6):525-6, 528-34
references.pmid: 15875145
references.citation: J Gastrointest Surg. 1997 Sep-Oct;1(5):408-22
references.pmid: 17061332
references.citation: Ann Surg Oncol. 2003 Nov;10(9):1007-11
references.pmid: 14597437
references.citation: AJR Am J Roentgenol. 2004 May;182(5):1233-40
references.pmid: 15100125
references.citation: Neth J Med. 2007 Jan;65(1):5-14
references.pmid: 17293634
references.citation: Arch Surg. 2005 Feb;140(2):183-9
references.pmid: 15724001
references.citation: J Am Coll Surg. 2004 Jun;198(6):884-91
references.pmid: 15194069
references.citation: World J Surg. 2002 Nov;26(11):1348-53
references.pmid: 12297926
references.citation: Gan To Kagaku Ryoho. 2006 Nov;33(12):1834-7
references.pmid: 17212121
references.citation: Ann Surg. 1999 Jul;230(1):31-7
references.pmid: 10400033
references.citation: Br J Surg. 2000 Sep;87(9):1142-55
references.pmid: 10971419
references.citation: World J Gastroenterol. 2003 Feb;9(2):193-200
references.pmid: 12532430
references.citation: Eur J Surg Oncol. 2006 Jun;32(5):557-63
references.pmid: 16580811
references.citation: HPB (Oxford). 2007;9(1):58-63
references.pmid: 18333114
references.citation: Eur J Surg Oncol. 2006 Jun;32(5):564-7
references.pmid: 16564155
references.citation: Br J Surg. 2007 Jul;94(7):855-9
references.pmid: 17380479