title: Outcome of patients with colorectal liver metastasis: analysis of 1,613 consecutive cases.
abstract: OBJECTIVE
  This study was designed to evaluate the long-time outcome of patients with colorectal liver metastasis (CRLM) undergoing different types of therapy and identify prognosis factors.
  
  
  METHODS
  From 2000 to 2010, 1,613 consecutive patients with CRLM were identified. Clinicopathological and outcome data were collected and analyzed by univariate and multivariate analyses.
  
  
  RESULTS
  Synchronous liver metastasis (SLM), female, grade III-IV, T4 and N positive of primary tumor, bilobar disease, number of liver metastases ≥ 4, size of largest liver metastases ≥ 5 cm, serum CEA level ≥ 5 ng/ml, and CA19-9 level ≥ 37 u/ml were the predictors of adverse outcome using univariate analysis. The median survival and 5-year survival rate for patients after resection of liver metastases was 49.8 months and 47%, better than that for those after other therapy. In addition, patients without treatment had the poorest survival. Sixty-four initially unresectable patients underwent surgery after conversion therapy with a median survival of 36.9 months and a 5-year survival of 30%. By multivariate analysis, SLM, poorly differentiated primary tumor, number of liver metastases ≥ 4, size of largest liver metastases ≥ 5 cm, and no surgical treatment of liver metastases were found to be independent predictors of poor survival.
  
  
  CONCLUSIONS
  Patients with CRLM could get long-term survival benefit from different types of therapy, and resection of liver metastases was the optimal strategy. A predictive model using these above five factors may be of use in stratifying patients who may benefit from intensive surveillance and adjuvant therapy.
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University Medical Center, Shanghai, People's Republic of China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Dexiang
authors.forename: Ren
authors.initials: R
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Ye
authors.forename: Wu
authors.initials: W
authors.lastname: Haifu
authors.forename: Zhong
authors.initials: Z
authors.lastname: Yunshi
authors.forename: Ye
authors.initials: Y
authors.lastname: Qinghai
authors.forename: Zhai
authors.initials: Z
authors.lastname: Shenyong
authors.forename: Xu
authors.initials: X
authors.lastname: Bo
authors.forename: Liang
authors.initials: L
authors.lastname: Li
authors.forename: Pan
authors.initials: P
authors.lastname: Xiangou
authors.forename: Li
authors.initials: L
authors.lastname: Haohao
authors.forename: Ye
authors.initials: Y
authors.lastname: Lechi
authors.forename: Liu
authors.initials: L
authors.lastname: Tianshu
authors.forename: Fan
authors.initials: F
authors.lastname: Jia
authors.forename: Qin
authors.initials: Q
authors.lastname: Xinyu
authors.forename: Xu
authors.initials: X
authors.lastname: Jianmin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D018395:CA-19-9 Antigen / Q000097:blood; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000069287:Capecitabine; D002272:Carcinoembryonic Antigen / Q000097:blood; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000473:pathology*; D003452:Cryosurgery; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010071:Oxaloacetates; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D009944:Organoplatinum Compounds; D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin