Top

International Journal of Colorectal Disease

Published in:

01-08-2011 | Review

Predictors of long-term survival in patients with colorectal liver metastases: a single center study and review of the literature

Authors: Utz Settmacher, Yves Dittmar, Thomas Knösel, Ulrike Schöne, Michael Heise, Karin Jandt, Annelore Katharina Altendorf-Hofmann

Published in: International Journal of Colorectal Disease | Issue 8/2011

Abstract

Purpose

Prognosis after resection of liver metastases of colorectal cancer is influenced by a variety of clinical factors. For more than 20 years, efforts have been made to restructure and simplify prognostic parameters into clinical scores. We evaluated the influence of various clinical and pathological factors on survival and recurrence and developed a simple model for risk stratification.

Methods

We have analyzed a total of 13 prognostic factors in 382 consecutive and prospectively enrolled R0-resected patients and applied our data set to ten published prognostic scoring systems. Prognostic factors that influenced disease-specific and disease-free survival were included into a model clinical risk score.

Results

The 5- and 10-year observed survival rates were 43% and 28%, respectively, for all 382 patients. The disease-specific 5- and 10-year survival rates were 49% and 37%, respectively; the 5- and 10-year recurrence rates were 68% and 70%, respectively. For patients with synchronous liver metastases, survival was not affected by the timing of liver resection. The prognosis after treatment of any recurrence was best after the accomplishment of a repeated R0 situation, independent of the location of the recurrence. In the multivariate analysis, the disease-specific survival and recurrence rates were statistically significantly influenced by more than three lymph node metastases of the primary tumor, more than two lesions within the liver, and the presence of extrahepatic tumor.

Conclusions

From these data, we have developed a simple score for the risk stratification which may be useful for future studies on interdisciplinary management of colorectal liver metastases.

Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230(3):309–318, discussion 318-321PubMedCrossRef

Iwatsuki S, Dvorchik I, Madariaga JR, Marsh JW, Dodson F, Bonham AC, Geller DA, Gayowski TJ, Fung JJ, Starzl TE (1999) Hepatic resection for metastatic colorectal adenocarcinoma: a proposal of a prognostic scoring system. J Am Coll Surg 189(3):291–299. doi:S1072751599000897 PubMedCrossRef

Konopke R, Kersting S, Distler M, Dietrich J, Gastmeier J, Heller A, Kulisch E, Saeger HD (2009) Prognostic factors and evaluation of a clinical score for predicting survival after resection of colorectal liver metastases. Liver Int 29(1):89–102. doi:10.1111/j.1478-3231.2008.01845.x PubMedCrossRef

Lee WS, Kim MJ, Yun SH, Chun HK, Lee WY, Kim SJ, Choi SH, Heo JS, Joh JW, Kim YI (2008) Risk factor stratification after simultaneous liver and colorectal resection for synchronous colorectal metastasis. Langenbecks Arch Surg 393(1):13–19. doi:10.1007/s00423-007-0231-0 PubMedCrossRef

Nagashima I, Takada T, Matsuda K, Adachi M, Nagawa H, Muto T, Okinaga K (2004) A new scoring system to classify patients with colorectal liver metastases: Proposal of criteria to select candidates for hepatic resection. J Hepatobiliary Pancreat Surg 11(2):79–83. doi:10.1007/s00534-002-0778-7 PubMedCrossRef

Nordlinger B, Guiguet M, Vaillant JC, Balladur P, Boudjema K, Bachellier P, Jaeck D (1996) Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association francaise de chirurgie. Cancer 77(7):1254–1262. doi:10.1002/(SICI)1097-0142(19960401)77:7<1254::AID-CNCR5>3.0.CO;2-I PubMedCrossRef

Rees M, Tekkis PP, Welsh FK, O'Rourke T, John TG (2008) Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg 247(1):125–135. doi:10.1097/SLA.0b013e31815aa2c2 PubMedCrossRef

Carpizo DR, Are C, Jarnagin W, Dematteo R, Fong Y, Gonen M, Blumgart L, D'Angelica M (2009) Liver resection for metastatic colorectal cancer in patients with concurrent extrahepatic disease: results in 127 patients treated at a single center. Ann Surg Oncol 16(8):2138–2146. doi:10.1245/s10434-009-0521-6 PubMedCrossRef

Elias D, Liberale G, Vernerey D, Pocard M, Ducreux M, Boige V, Malka D, Pignon JP, Lasser P (2005) Hepatic and extrahepatic colorectal metastases: when resectable, their localization does not matter, but their total number has a prognostic effect. Ann Surg Oncol 12(11):900–909. doi:10.1245/ASO.2005.01.010 PubMedCrossRef

10.

Schmiegel W, Pox C, Reinacher-Schick A, Adler G, Arnold D, Fleig W, Folsch UR, Fruhmorgen P, Graeven U, Heinemann V, Hohenberger W, Holstege A, Junginger T, Kopp I, Kuhlbacher T, Porschen R, Propping P, Riemann JF, Rodel C, Sauer R, Sauerbruch T, Schmitt W, Schmoll HJ, Seufferlein T, Zeitz M, Selbmann HK (2010) S3 guidelines for colorectal carcinoma: results of an evidence-based consensus conference on february 6/7, 2004 and june 8/9, 2007 (for the topics iv, vi and vii). Z Gastroenterol 48(1):65–136. doi:10.1055/s-0028-1109936 PubMedCrossRef

11.

Folprecht G, Gruenberger T, Bechstein WO, Raab HR, Lordick F, Hartmann JT, Lang H, Frilling A, Stoehlmacher J, Weitz J, Konopke R, Stroszczynski C, Liersch T, Ockert D, Herrmann T, Goekkurt E, Parisi F, Kohne CH (2010) Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the celim randomised phase 2 trial. Lancet Oncol 11(1):38–47. doi:10.1016/S1470-2045(09)70330-4 PubMedCrossRef

12.

Abdalla EK, Vauthey JN, Ellis LM, Ellis V, Pollock R, Broglio KR, Hess K, Curley SA (2004) Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 239(6):818–825, discussion 825-817PubMedCrossRef

13.

Choti MA, Sitzmann JV, Tiburi MF, Sumetchotimetha W, Rangsin R, Schulick RD, Lillemoe KD, Yeo CJ, Cameron JL (2002) Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg 235(6):759–766PubMedCrossRef

14.

Fernandez FG, Drebin JA, Linehan DC, Dehdashti F, Siegel BA, Strasberg SM (2004) Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with f-18 fluorodeoxyglucose (fdg-pet). Ann Surg 240(3):438–447, discussion 447-450PubMedCrossRef

15.

Pawlik TM, Scoggins CR, Zorzi D, Abdalla EK, Andres A, Eng C, Curley SA, Loyer EM, Muratore A, Mentha G, Capussotti L, Vauthey JN (2005) Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg 241(5):715–722, discussion 722-714PubMedCrossRef

16.

Pulitano C, Castillo F, Aldrighetti L, Bodingbauer M, Parks RW, Ferla G, Wigmore SJ, Garden OJ (2010) What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up. HPB (Oxford) 12(4):244–249. doi:10.1111/j.1477-2574.2010.00155.x

17.

Tomlinson JS, Jarnagin WR, DeMatteo RP, Fong Y, Kornprat P, Gonen M, Kemeny N, Brennan MF, Blumgart LH, D'Angelica M (2007) Actual 10-year survival after resection of colorectal liver metastases defines cure. J Clin Oncol 25(29):4575–4580. doi:10.1200/JCO.2007.11.0833 PubMedCrossRef

18.

Vigano L, Ferrero A, Lo Tesoriere R, Capussotti L (2008) Liver surgery for colorectal metastases: results after 10 years of follow-up. Long-term survivors, late recurrences, and prognostic role of morbidity. Ann Surg Oncol 15(9):2458–2464. doi:10.1245/s10434-008-9935-9 PubMedCrossRef

19.

Altendorf-Hofmann A, Scheele J (2003) A critical review of the major indicators of prognosis after resection of hepatic metastases from colorectal carcinoma. Surg Oncol Clin N Am 12(1):165–192, xiPubMedCrossRef

20.

Neal CP, Mann CD, Sutton CD, Garcea G, Ong SL, Steward WP, Dennison AR, Berry DP (2009) Evaluation of the prognostic value of systemic inflammation and socioeconomic deprivation in patients with resectable colorectal liver metastases. Eur J Cancer 45(1):56–64. doi:10.1016/j.ejca.2008.08.019 PubMedCrossRef

21.

Gomez D, Morris-Stiff G, Wyatt J, Toogood GJ, Lodge JP, Prasad KR (2008) Surgical technique and systemic inflammation influences long-term disease-free survival following hepatic resection for colorectal metastasis. J Surg Oncol 98(5):371–376. doi:10.1002/jso.21103 PubMedCrossRef

22.

Halazun KJ, Aldoori A, Malik HZ, Al-Mukhtar A, Prasad KR, Toogood GJ, Lodge JP (2008) Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol 34(1):55–60. doi:10.1016/j.ejso.2007.02.014 PubMed

23.

Blazer DG 3rd, Kishi Y, Maru DM, Kopetz S, Chun YS, Overman MJ, Fogelman D, Eng C, Chang DZ, Wang H, Zorzi D, Ribero D, Ellis LM, Glover KY, Wolff RA, Curley SA, Abdalla EK, Vauthey JN (2008) Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases. J Clin Oncol 26(33):5344–5351. doi:10.1200/JCO.2008.17.5299 PubMedCrossRef

24.

Small RM, Lubezky N, Shmueli E, Figer A, Aderka D, Nakache R, Klausner JM, Ben-Haim M (2009) Response to chemotherapy predicts survival following resection of hepatic colo-rectal metastases in patients treated with neoadjuvant therapy. J Surg Oncol 99(2):93–98. doi:10.1002/jso.21207 PubMedCrossRef

25.

Scheele J, Altendorf-Hofmann A, Grube T, Hohenberger W, Stangl R, Schmidt K (2001) resection of colorectal liver metastases. What prognostic factors determine patient selection? Chirurg 72(5):547–560PubMedCrossRef

26.

Rajaganeshan R, Prasad R, Guillou PJ, Chalmers CR, Scott N, Sarkar R, Poston G, Jayne DG (2007) The influence of invasive growth pattern and microvessel density on prognosis in colorectal cancer and colorectal liver metastases. Br J Cancer 96(7):1112–1117. doi:10.1038/sj.bjc.6603677 PubMedCrossRef

27.

Koch M, Kienle P, Hinz U, Antolovic D, Schmidt J, Herfarth C, von Knebel DM, Weitz J (2005) Detection of hematogenous tumor cell dissemination predicts tumor relapse in patients undergoing surgical resection of colorectal liver metastases. Ann Surg 241(2):199–205PubMedCrossRef

28.

Vogelaar FJ, Mesker WE, Rijken AM, van Pelt GW, van Leeuwen AM, Tanke HJ, Tollenaar RA, Liefers GJ (2010) Clinical impact of different detection methods for disseminated tumor cells in bone marrow of patients undergoing surgical resection of colorectal liver metastases: a prospective follow-up study. BMC Cancer 10:153. doi:10.1186/1471-2407-10-153 PubMedCrossRef

29.

de Haas RJ, Wicherts DA, Flores E, Ducreux M, Levi F, Paule B, Azoulay D, Castaing D, Lemoine A, Adam R (2010) Tumor marker evolution: comparison with imaging for assessment of response to chemotherapy in patients with colorectal liver metastases. Ann Surg Oncol 17(4):1010–1023. doi:10.1245/s10434-009-0887-5 PubMedCrossRef

30.

Knösel T, Schluns K, Stein U, Schwabe H, Schlag PM, Dietel M, Petersen I (2004) Chromosomal alterations during lymphatic and liver metastasis formation of colorectal cancer. Neoplasia 6(1):23–28PubMed

31.

Mollevi DG, Serrano T, Ginesta MM, Valls J, Torras J, Navarro M, Ramos E, Germa JR, Jaurrieta E, Moreno V, Figueras J, Capella G, Villanueva A (2007) Mutations in tp53 are a prognostic factor in colorectal hepatic metastases undergoing surgical resection. Carcinogenesis 28(6):1241–1246. doi:10.1093/carcin/bgm012 PubMedCrossRef

32.

Nash GM, Gimbel M, Shia J, Nathanson DR, Ndubuisi MI, Zeng ZS, Kemeny N, Paty PB (2009) Kras mutation correlates with accelerated metastatic progression in patients with colorectal liver metastases. Ann Surg Oncol 17(2):572–578. doi:10.1245/s10434-009-0605-3 PubMedCrossRef

33.

Adam R, Avisar E, Ariche A, Giachetti S, Azoulay D, Castaing D, Kunstlinger F, Levi F, Bismuth F (2001) Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal. Ann Surg Oncol 8(4):347–353PubMedCrossRef

34.

Nordlinger B, Van Cutsem E, Gruenberger T, Glimelius B, Poston G, Rougier P, Sobrero A, Ychou M (2009) Combination of surgery and chemotherapy and the role of targeted agents in the treatment of patients with colorectal liver metastases: recommendations from an expert panel. Ann Oncol 20(6):985–992. doi:10.1093/annonc/mdn735 PubMedCrossRef

35.

Hillingso JG, Wille-Jorgensen P (2009) Staged or simultaneous resection of synchronous liver metastases from colorectal cancer–a systematic review. Colorectal Dis 11(1):3–10. doi:10.1111/j.1463-1318.2008.01625.x PubMedCrossRef

36.

Chen J, Li Q, Wang C, Zhu H, Shi Y, Zhao G (2011) Simultaneous vs. Staged resection for synchronous colorectal liver metastases: a metaanalysis. Int J Colorectal Dis 26(2):191–199. doi:10.1007/s00384-010-1018-2 PubMedCrossRef

37.

Oussoultzoglou E, Romain B, Panaro F, Rosso E, Pessaux P, Bachellier P, Jaeck D (2009) Long-term survival after liver resection for colorectal liver metastases in patients with hepatic pedicle lymph nodes involvement in the era of new chemotherapy regimens. Ann Surg 249(6):879–886. doi:10.1097/SLA.0b013e3181a334d9 PubMedCrossRef

38.

Gurusamy KS, Imber C, Davidson BR (2008) Management of the hepatic lymph nodes during resection of liver metastases from colorectal cancer: a systematic review. HPB Surg 2008:684150. doi:10.1155/2008/684150 PubMedCrossRef

39.

Ambiru S, Miyazaki M, Isono T, Ito H, Nakagawa K, Shimizu H, Kusashio K, Furuya S, Nakajima N (1999) Hepatic resection for colorectal metastases: analysis of prognostic factors. Dis Colon Rectum 42(5):632–639PubMedCrossRef

40.

Laurent C, Sa Cunha A, Rullier E, Smith D, Rullier A, Saric J (2004) Impact of microscopic hepatic lymph node involvement on survival after resection of colorectal liver metastasis. J Am Coll Surg 198(6):884–891. doi:10.1016/j.jamcollsurg.2004.01.017 PubMedCrossRef

41.

Gurusamy KS, Ramamoorthy R, Imber C, Davidson BR (2010) Surgical resection versus non-surgical treatment for hepatic node positive patients with colorectal liver metastases. Cochrane Database Syst Rev (1):CD006797. doi:10.1002/14651858.CD006797.pub2

42.

de Jong MC, Pulitano C, Ribero D, Strub J, Mentha G, Schulick RD, Choti MA, Aldrighetti L, Capussotti L, Pawlik TM (2009) Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients. Ann Surg 250(3):440–448. doi:10.1097/SLA.0b013e3181b4539b PubMed

43.

Jaeck D, Bachellier P, Guiguet M, Feldo M, Vaillant JC, Balladur P, Nordlinger B (1997) Survival benefit of repeat liver resection for recurrent colorectal metastases: 143 cases. Wiad Lek 50(Suppl 1 Pt 1):102–104PubMed

44.

Matsuda K, Hotta T, Uchiyama K, Tani M, Takifuji K, Yokoyama S, Higashiguchi T, Tominaga T, Oku Y, Nasu T, Yamaue H (2007) Repeat reduction surgery after an initial hepatectomy for patients with colorectal cancer. Oncol Rep 18(1):189–194PubMed

45.

Takahashi S, Inoue K, Konishi M, Nakagouri T, Kinoshita T (2003) Prognostic factors for poor survival after repeat hepatectomy in patients with colorectal liver metastases. Surgery 133(6):627–634. doi:10.1067/msy.2003.151 PubMedCrossRef

46.

Adam R, Bismuth H, Castaing D, Waechter F, Navarro F, Abascal A, Majno P, Engerran L (1997) Repeat hepatectomy for colorectal liver metastases. Ann Surg 225(1):51–60, discussion 60-52PubMedCrossRef

47.

Adam R, Pascal G, Azoulay D, Tanaka K, Castaing D, Bismuth H (2003) Liver resection for colorectal metastases: The third hepatectomy. Ann Surg 238 (6):871–883; discussion 883-874. doi:10.1097/01.sla.0000098112.04758.4e

48.

Ahmad A, Chen SL, Bilchik AJ (2007) Role of repeated hepatectomy in the multimodal treatment of hepatic colorectal metastases. Arch Surg 142(6):526–531; discussion 531-522. doi:10.1001/archsurg.142.6.526 PubMedCrossRef

49.

Antoniou A, Lovegrove RE, Tilney HS, Heriot AG, John TG, Rees M, Tekkis PP, Welsh FK (2007) Meta-analysis of clinical outcome after first and second liver resection for colorectal metastases. Surgery 141(1):9–18. doi:10.1016/j.surg.2006.07.045 PubMedCrossRef

50.

Brachet D, Lermite E, Rouquette A, Lorimier G, Hamy A, Arnaud JP (2009) Prognostic factors of survival in repeat liver resection for recurrent colorectal metastases: review of sixty-two cases treated at a single institution. Dis Colon Rectum 52(3):475–483. doi:10.1007/DCR.0b013e31819d12bc PubMedCrossRef

51.

Fernandez-Trigo V, Shamsa F, Sugarbaker PH (1995) Repeat liver resections from colorectal metastasis. Repeat hepatic metastases registry Surgery 117(3):296–304

52.

Nishio H, Hamady ZZ, Malik HZ, Fenwick S, Rajendra Prasad K, Toogood GJ, Lodge JP (2007) Outcome following repeat liver resection for colorectal liver metastases. Eur J Surg Oncol 33(6):729–734. doi:10.1016/j.ejso.2006.07.005 PubMed

53.

Pessaux P, Lermite E, Brehant O, Tuech JJ, Lorimier G, Arnaud JP (2006) Repeat hepatectomy for recurrent colorectal liver metastases. J Surg Oncol 93(1):1–7. doi:10.1002/jso.20384 PubMedCrossRef

54.

Shaw IM, Rees M, Welsh FK, Bygrave S, John TG (2006) Repeat hepatic resection for recurrent colorectal liver metastases is associated with favourable long-term survival. Br J Surg 93(4):457–464. doi:10.1002/bjs.5323 PubMedCrossRef

55.

Thelen A, Jonas S, Benckert C, Schumacher G, Lopez-Hanninen E, Rudolph B, Neumann U, Neuhaus P (2007) Repeat liver resection for recurrent liver metastases from colorectal cancer. Eur J Surg Oncol 33(3):324–328. doi:10.1016/j.ejso.2006.10.016 PubMed

56.

Aldrighetti L, Castoldi R, Di Palo S, Arru M, Stella M, Orsenigo E, Gavazzi F, Ferla G, Di Carlo V, Staudacher C (2005) prognostic factors for long-term outcome of hepatic resection for colorectal liver metastases. Chir Ital 57(5):555–570PubMed

57.

House MG, Ito H, Gonen M, Fong Y, Allen PJ, DeMatteo RP, Brennan MF, Blumgart LH, Jarnagin WR, D'Angelica MI (2010) Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. J Am Coll Surg 210(5):744–752. doi:10.1016/j.jamcollsurg.2009.12.040, 752-745PubMedCrossRef

58.

Jarnagin WR, Conlon K, Bodniewicz J, Dougherty E, DeMatteo RP, Blumgart LH, Fong Y (2001) A clinical scoring system predicts the yield of diagnostic laparoscopy in patients with potentially resectable hepatic colorectal metastases. Cancer 91(6):1121–1128. doi:10.1002/1097-0142(20010315)91:6<1121::AID-CNCR1108>3.0.CO;2-2 PubMedCrossRef

59.

Mala T, Bohler G, Mathisen O, Bergan A, Soreide O (2002) Hepatic resection for colorectal metastases: can preoperative scoring predict patient outcome? World J Surg 26(11):1348–1353. doi:10.1007/s00268-002-6231-x PubMedCrossRef

60.

Mann CD, Metcalfe MS, Leopardi LN, Maddern GJ (2004) The clinical risk score: emerging as a reliable preoperative prognostic index in hepatectomy for colorectal metastases. Arch Surg 139(11):1168–1172. doi:10.1001/archsurg.139.11.1168 PubMedCrossRef

61.

Mehta KR, Nakao K, Zuraek MB, Ruan DT, Bergsland EK, Venook AP, Moore DH, Tokuyasu TA, Jain AN, Warren RS, Terdiman JP, Waldman FM (2005) Fractional genomic alteration detected by array-based comparative genomic hybridization independently predicts survival after hepatic resection for metastatic colorectal cancer. Clin Cancer Res 11(5):1791–1797. doi:10.1158/1078-0432.CCR-04-1418 PubMedCrossRef

62.

Grobmyer SR, Fong Y, D'Angelica M, Dematteo RP, Blumgart LH, Jarnagin WR (2004) Diagnostic laparoscopy prior to planned hepatic resection for colorectal metastases. Arch Surg 139(12):1326–1330. doi:10.1001/archsurg.139.12.1326 PubMedCrossRef

63.

Ivanecz A, Potrc S, Horvat M, Jagric T, Gadzijev E (2009) The validity of clinical risk score for patients undergoing liver resection for colorectal metastases. Hepatogastroenterology 56(94–95):1452–1458PubMed

64.

Mann CD, Neal CP, Metcalfe MS, Pattenden CJ, Dennison AR, Berry DP (2007) Clinical risk score predicts yield of staging laparoscopy in patients with colorectal liver metastases. Br J Surg 94(7):855–859. doi:10.1002/bjs.5730 PubMedCrossRef

65.

Lise M, Bacchetti S, Da Pian P, Nitti D, Pilati P (2001) Patterns of recurrence after resection of colorectal liver metastases: Prediction by models of outcome analysis. World J Surg 25(5):638–644. doi:10.1007/s002680020138 PubMedCrossRef

66.

Malik HZ, Prasad KR, Halazun KJ, Aldoori A, Al-Mukhtar A, Gomez D, Lodge JP, Toogood GJ (2007) Preoperative prognostic score for predicting survival after hepatic resection for colorectal liver metastases. Ann Surg 246(5):806–814. doi:10.1097/SLA.0b013e318142d964 PubMedCrossRef

67.

Minagawa M, Yamamoto J, Kosuge T, Matsuyama Y, Miyagawa S, Makuuchi M (2007) Simplified staging system for predicting the prognosis of patients with resectable liver metastasis: Development and validation. Arch Surg 142(3):269–276; discussion 277. doi:10.1001/archsurg.142.3.269

68.

Reissfelder C, Rahbari NN, Koch M, Ulrich A, Pfeilschifter I, Waltert A, Muller SA, Schemmer P, Buchler MW, Weitz J (2009) Validation of prognostic scoring systems for patients undergoing resection of colorectal cancer liver metastases. Ann Surg Oncol 16 (12):3279–3288. doi:10.1245/s10434-009-0654-7

69.

Schindl M, Wigmore SJ, Currie EJ, Laengle F, Garden OJ (2005) Prognostic scoring in colorectal cancer liver metastases: development and validation. Arch Surg 140(2):183–189. doi:10.1001/archsurg.140.2.183 PubMedCrossRef

70.

Ishizuka D, Shirai Y, Sakai Y, Hatakeyama K (2001) Colorectal carcinoma liver metastases: clinical significance of preoperative measurement of serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels. Int J Colorectal Dis 16(1):32–37PubMedCrossRef

Title: Predictors of long-term survival in patients with colorectal liver metastases: a single center study and review of the literature
Authors: Utz Settmacher
Yves Dittmar
Thomas Knösel
Ulrike Schöne
Michael Heise
Karin Jandt
Annelore Katharina Altendorf-Hofmann
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 8/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-011-1195-7

At a glance: The STEP trials

Springer Medicine

Predictors of long-term survival in patients with colorectal liver metastases: a single center study and review of the literature

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2011

Overall and KRAS-specific results of combined cetuximab treatment and chemotherapy for metastatic colorectal cancer: a meta-analysis

Emergency surgery in colonic diverticulitis in an Asian population

Botulin toxin type A (BTA) for esophageal achalasia: a double-edged sword

KRAS mutation analysis as a diagnostic tool

Identification of heat shock protein 90α as an IMH-2 epitope-associated protein and correlation of its mRNA overexpression with colorectal cancer metastasis and poor prognosis

Role of CT colonography in symptomatic assessment, surveillance and screening