title: Impact of grading of liver metastasis on postoperative outcome in patients with liver metastases from colorectal cancer.
abstract: OBJECTIVE
  Few studies have investigated grading of liver metastasis (GLM) in patients with liver metastases from colorectal cancer (LM-CRC).
  
  
  METHODS
  To screen for the most useful predictive factors in patients undergoing hepatic resection for LM-CRC, clinico-pathological factors were subjected to uni- and multivariate analyses.
  
  
  RESULTS
  One hundred and twenty-five patients were evaluated retrospectively. Univariate analyses using clinico-laboratory factors demonstrated that nomogram, gender, CRP, albumin, number of hepatic resections, liver metastasis (H) and GLM were related to postoperative death. Multivariate analysis using these seven factors disclosed that albumin (OR, 6.949; 95% CI, 1.994-24.22; p=0.002), CRP (OR, 6.977; 95% CI, 1.937-25.14; p=0.003) and GLM (OR, 2.819; 95% CI, 1.082-7.346; p=0.034) were associated with postoperative death. Kaplan-Meier analysis and log rank test revealed that higher GLM (p<0.001) and CRP (p<0.001) were associated with a higher rate of postoperative death. GLM was able to divide the patients into three independent groups with significantly different total nomogram counts (p<0.001, Kruskal-Wallis test).
  
  
  CONCLUSIONS
  GLM is able to classify patients with LM-CRC into three independent groups and offers reliable information for predicting postoperative death in such patients.
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan. mm-ishizuka@umin.ac.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ishizuka
authors.forename: Junji
authors.initials: J
authors.lastname: Kita
authors.forename: Mitsugi
authors.initials: M
authors.lastname: Shimoda
authors.forename: Masato
authors.initials: M
authors.lastname: Kato
authors.forename: Tokihiko
authors.initials: T
authors.lastname: Sawada
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D049451:Nomograms; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome