BACKGROUND: The aim of this study was to analyze the prognostic factors associated with long-term outcome after liver resection for colorectal metastases. The retrospective analysis included 297 liver resections for colorectal metastases. METHODS: The variables considered included disease stage, differentiation grade, site and nodal metastasis of the primary tumor, number and diameter of the lesions, time from primary cancer to metastasis, preoperative carcinoembryonic antigen (CEA) level, adjuvant chemotherapy, type of resection, intraoperative ultrasonography and portal clamping use, blood loss, transfusions, complications, hospitalization, surgical margins status, and a clinical risk score (MSKCC-CRS). RESULTS: The univariate analysis revealed a significant difference (p < 0.05) in overall 5-year survival rates depending on the differentiation grade, preoperative CEA >5 and >200 ng/ml, diameter of the lesion >5 cm, time from primary tumor to metastases >12 months, MSKCC-CRS >2. The multivariate analysis showed three independent negative prognostic factors: G3 or G4 grade, CEA >5 ng/ml, and high MSKCC-CRS. CONCLUSIONS: No single prognostic factor proved to be associated with a sufficiently disappointing outcome to exclude patients from liver resection. However, in the presence of some prognostic factors (G3-G4 differentiation, preoperative CEA >5 ng/ml, high MSKCC-CRS), enrollment of patients in trials exploring new adjuvant treatments is suggested to improve the outcome after surgery.
BACKGROUND: The aim of this study was to analyze the prognostic factors associated with long-term outcome after liver resection for colorectal metastases. The retrospective analysis included 297 liver resections for colorectal metastases. METHODS: The variables considered included disease stage, differentiation grade, site and nodal metastasis of the primary tumor, number and diameter of the lesions, time from primary cancer to metastasis, preoperative carcinoembryonic antigen (CEA) level, adjuvant chemotherapy, type of resection, intraoperative ultrasonography and portal clamping use, blood loss, transfusions, complications, hospitalization, surgical margins status, and a clinical risk score (MSKCC-CRS). RESULTS: The univariate analysis revealed a significant difference (p < 0.05) in overall 5-year survival rates depending on the differentiation grade, preoperative CEA >5 and >200 ng/ml, diameter of the lesion >5 cm, time from primary tumor to metastases >12 months, MSKCC-CRS >2. The multivariate analysis showed three independent negative prognostic factors: G3 or G4 grade, CEA >5 ng/ml, and high MSKCC-CRS. CONCLUSIONS: No single prognostic factor proved to be associated with a sufficiently disappointing outcome to exclude patients from liver resection. However, in the presence of some prognostic factors (G3-G4 differentiation, preoperative CEA >5 ng/ml, high MSKCC-CRS), enrollment of patients in trials exploring new adjuvant treatments is suggested to improve the outcome after surgery.
Authors: Henrik Petrowsky; Mithat Gonen; William Jarnagin; Matthias Lorenz; Ronald DeMatteo; Stefan Heinrich; Albrecht Encke; Leslie Blumgart; Yuman Fong Journal: Ann Surg Date: 2002-06 Impact factor: 12.969
Authors: Timothy M Pawlik; Charles R Scoggins; Daria Zorzi; Eddie K Abdalla; Axel Andres; Cathy Eng; Steven A Curley; Evelyne M Loyer; Andrea Muratore; Gilles Mentha; Lorenzo Capussotti; Jean-Nicolas Vauthey Journal: Ann Surg Date: 2005-05 Impact factor: 12.969
Authors: Eduardo de Santibañes; Fernando Bonadeo Lassalle; Lucas McCormack; Juan Pekolj; Guillermo Ojea Quintana; Carlos Vaccaro; Mario Benati Journal: J Am Coll Surg Date: 2002-08 Impact factor: 6.113
Authors: Giorgio Ercolani; Gian Luca Grazi; Matteo Ravaioli; Matteo Cescon; Andrea Gardini; Giovanni Varotti; Massimo Del Gaudio; Bruno Nardo; Antonino Cavallari Journal: Arch Surg Date: 2002-10
Authors: David A Kooby; Jennifer Stockman; Leah Ben-Porat; Mithat Gonen; William R Jarnagin; Ronald P Dematteo; Scott Tuorto; David Wuest; Leslie H Blumgart; Yuman Fong Journal: Ann Surg Date: 2003-06 Impact factor: 12.969
Authors: Tony C Pang; Calista Spiro; Tim Ramacciotti; Julian Choi; Martin Drummond; Edmund Sweeney; Jaswinder S Samra; Thomas J Hugh Journal: HPB (Oxford) Date: 2014-08-26 Impact factor: 3.647
Authors: Michael A Morse; Donna Niedzwiecki; John L Marshall; Christopher Garrett; David Z Chang; Mebea Aklilu; Todd S Crocenzi; David J Cole; Sophie Dessureault; Amy C Hobeika; Takuya Osada; Mark Onaitis; Bryan M Clary; David Hsu; Gayathri R Devi; Anuradha Bulusu; Robert P Annechiarico; Vijaya Chadaram; Timothy M Clay; H Kim Lyerly Journal: Ann Surg Date: 2013-12 Impact factor: 12.969
Authors: D J Watkins; I Chau; D Cunningham; S S Mudan; N Karanjia; G Brown; S Ashley; A R Norman; A Gillbanks Journal: Br J Cancer Date: 2010-01-19 Impact factor: 7.640