title: Surgical treatment of liver metastases from colorectal cancer: experience of a single institution.
abstract: BACKGROUND
  This report analyses an experience with 42 liver resections for metastatic colorectal carcinoma.
  
  
  METHODS
  Forty-two patients underwent curative resection for liver metastasis from colorectal cancer between January 2004 and December 2007, with a follow up period that ranged from 3 to 66 months. In this retrospective study, early postoperative 30 day mortality and morbidity in addition to the effects of Dukes' stage, type of resection, number and size of the tumor, synchronous or metachronous metastases, resection margin, sex, age and chemotherapy protocol on three year survival were analyzed retrospectively. Univariate analyses of survival were estimated using the Kaplan-Meier method. Multivariate analysis was evaluated using Cox regression method. The value of P<0.05 was accepted as significant.
  
  
  RESULTS
  Early postoperative morbidity and mortality rates were 7.14% and 0%, respectively. Fourteen patients died during the follow-up period of 3 to 66 months (mean, 40.40±12.87). Median survival was 56 months and three year survival rate was 71.30%. Recurrence occurred in 11 patients (26.00%) after liver resection and additional surgery was performed for two of them. At univariate analysis, the number of tumors (<4), tumor size (<4 cm), type of resection and negative resection margins were significantly correlated with three year survival. Sex, age, Dukes' stage, synchronous or metachronous metastasis, recurrence and chemotherapy protocol were not predictive of long-term prognosis. Multivariate analysis revealed that tumor size>4 cm and presence of more than four tumors before surgery were associated with a 5.89 and 2.18-fold increased risk of death, respectively.
  
  
  CONCLUSIONS
  Curative resection is one of the most important treatment options that can demonstrate long-term survival for patients.
authors.affiliation: Ministry of Health Ankara Oncology Teaching and Research Hospital, General Surgery Department Demetevler, Ankara, Turkey. bkavlakoglu@hotmail.com
authors.forename: Burak
authors.initials: B
authors.lastname: Kavlakoglu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ustun
authors.forename: Oktay
authors.initials: O
authors.lastname: Oksuz
authors.forename: Recep
authors.initials: R
authors.lastname: Pekcici
authors.forename: Salih
authors.initials: S
authors.lastname: Ergocen
authors.forename: Suleyman
authors.initials: S
authors.lastname: Oral
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden