Pre-hepatectomy prognostic staging to determine treatment strategy for colorectal cancer metastases to the liver

Attempts at identifying prognostic factors after hepatectomy in patients with colorectal liver metastases have not achieved consensus. We investigated prognostic factors ascertainable before hepatectomy for colorectal metastasis. Clinicopathological data for 149 consecutive patients with colorectal...

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Published in:Langenbeck's archives of surgery 2004-10, Vol.389 (5), p.371-379
Main Authors: Tanaka, Kuniya, Shimada, Hiroshi, Fujii, Yoshirou, Endo, Itaru, Sekido, Hitoshi, Togo, Shinji, Ike, Hideyuki
Format: Article
Language:English
Subjects:
Colorectal Neoplasms
Disease-Free Survival
Female
Follow-Up Studies
Hepatectomy
Humans
Liver - pathology
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - pathology
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Male
Multivariate Analysis
Neoplasm Staging
Prognosis
Risk
Survival Analysis
Time Factors
Tomography, Spiral Computed
Tomography, X-Ray Computed
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Summary:Attempts at identifying prognostic factors after hepatectomy in patients with colorectal liver metastases have not achieved consensus. We investigated prognostic factors ascertainable before hepatectomy for colorectal metastasis. Clinicopathological data for 149 consecutive patients with colorectal cancer who underwent curative resection of primary lesions and metastatic liver disease at one institution were subjected to multivariate analysis concerning metastatic status and the primary lesion. Poorly differentiated adenocarcinoma or mucinous carcinoma as the primary tumor (Poor/muc; P=0.026), marked vascular invasion by the primary tumor (V; P=0.002), bi-lobar liver metastases ( P=0.048), and short doubling time (DT) of the liver tumor ( P=0.028) were characteristics assessable before hepatectomy that independently indicated poorer survival. A four-stage classification based on these factors was related to overall ( P
ISSN:1435-2443
1435-2451
DOI:10.1007/s00423-004-0490-y