title: Scoring of prognostic factors that influence long-term survival in patients with hepatic metastasis of colorectal cancer.
abstract: OBJECTIVE
  To find independent predictors that affect the survival in patients with hepatic metastasis of colorectal cancer after surgery and to devise a risk scoring system.
  
  
  METHODS
  Among 150 patients who underwent hepatic resection after diagnosis of colorectal cancer with hepatic metastasis between March 1994 and February 2009, we analyzed clinical, pathologic and outcome data retrospectively.
  
  
  RESULTS
  The 1-year survival rate was 83%, and the 5-year survival rate was 35%. Nine factors were found to be independent predictors of adverse outcome by univariate analysis: stage of primary tumor, CA19-9 >36 U/ml, extrahepatic disease, distribution of the hepatic tumor, number of hepatic tumors >3, largest hepatic tumor >5 cm, total size >10 cm, CEA >10 ng/ml, and metachronous cancer. The last two of these criteria were also significant risk factors on multivariate analysis. When these criteria were used as a risk scoring system, assigning one point for each criterion and dividing the cases into A, B and C groups, the total score was highly predictive of outcomes (p<0.001). No patients in group C (6 to 9 points) were long-term survivors.
  
  
  CONCLUSIONS
  Long-term outcome can be predicted from nine criteria that are readily available for all patients. Patients meeting up to two criteria (group A) are more likely to have a favorable outcome compared to the three or over (groups B and C). This scoring system may offer an easy, rapid, and reliable prognostic indicator of survival outcome after hepatic resection in patients with hepatic metastasis from colorectal cancer.
authors.affiliation: Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Ahn
authors.affiliation: Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Ahn Soo
authors.initials: AS
authors.lastname: Na
authors.affiliation: Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Jae Do
authors.initials: JD
authors.lastname: Yang
authors.affiliation: Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Hong Pil
authors.initials: HP
authors.lastname: Hwang
authors.affiliation: Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Yu
authors.affiliation: Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Baik Hwan
authors.initials: BH
authors.lastname: Cho
keywords: Clinical risk scoring system; Colorectal cancer; Hepatic metastasis; Hepatic resection