title: Predictors of long-term survival in patients with colorectal liver metastases: a single center study and review of the literature.
abstract: OBJECTIVE
  Prognosis after resection of liver metastases of colorectal cancer is influenced by a variety of clinical factors. For more than 20 years, efforts have been made to restructure and simplify prognostic parameters into clinical scores. We evaluated the influence of various clinical and pathological factors on survival and recurrence and developed a simple model for risk stratification.
  
  
  METHODS
  We have analyzed a total of 13 prognostic factors in 382 consecutive and prospectively enrolled R0-resected patients and applied our data set to ten published prognostic scoring systems. Prognostic factors that influenced disease-specific and disease-free survival were included into a model clinical risk score.
  
  
  RESULTS
  The 5- and 10-year observed survival rates were 43% and 28%, respectively, for all 382 patients. The disease-specific 5- and 10-year survival rates were 49% and 37%, respectively; the 5- and 10-year recurrence rates were 68% and 70%, respectively. For patients with synchronous liver metastases, survival was not affected by the timing of liver resection. The prognosis after treatment of any recurrence was best after the accomplishment of a repeated R0 situation, independent of the location of the recurrence. In the multivariate analysis, the disease-specific survival and recurrence rates were statistically significantly influenced by more than three lymph node metastases of the primary tumor, more than two lesions within the liver, and the presence of extrahepatic tumor.
  
  
  CONCLUSIONS
  From these data, we have developed a simple score for the risk stratification which may be useful for future studies on interdisciplinary management of colorectal liver metastases.
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital Jena, Erlanger Allee 101, Jena, 07740, Germany. utz.settmacher@med.uni-jena.de
authors.forename: Utz
authors.initials: U
authors.lastname: Settmacher
authors.forename: Yves
authors.initials: Y
authors.lastname: Dittmar
authors.forename: Thomas
authors.initials: T
authors.lastname: Knösel
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schöne
authors.forename: Michael
authors.initials: M
authors.lastname: Heise
authors.forename: Karin
authors.initials: K
authors.lastname: Jandt
authors.forename: Annelore Katharina
authors.initials: AK
authors.lastname: Altendorf-Hofmann
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D015999:Multivariate Analysis; D012008:Recurrence; D013997:Time Factors