SURGICAL RESECTION OF COLORECTAL-CARCINOMA METASTASES TO THE LIVER - A PROGNOSTIC SCORING SYSTEM TO IMPROVE CASE SELECTION, BASED ON 1568 PATIENTS

BACKGROUND. Five-year survival rates after resection of liver metastas es from colorectal carcinoma are close to 25%. Recurrences occur in tw o-thirds of the patients after surgery. Selection of patients likely t o benefit from surgery remains controversial and subjective. METHODS. Data from 1568 patients with resected liver metastases from colorectal carcinoma were collected. The prognostic value of different factors w as studied through uni- and multivariate analyses. A scoring system wa s developed including the most relevant factors. RESULTS. Two- and 5-y ear survival rates were 64% and 28%, respectively, and were affected b y: age; size of largest metastasis or CEA level; stage of the primary tumor; disease free interval; number of liver nodules; and resection m argin. Giving one point to each factor, the population was divided int o three risk groups with different 2-year survival rates: 0-2 (79%), 3 -4 (60%), 5-7 (43%). CONCLUSIONS. A simple prognostic scoring system w as proposed to evaluate the chances for cure of patients after resecti on of liver metastases from colorectal carcinoma. The comparison betwe en expected survival and estimated operative risk can help determine o n an objective basis whether surgery is worthwhile. This system needs further prospective validation. (C) 1996 American Cancer Society.