A New Staging System for Colorectal Carcinoma with Liver Metastasis

Abstract

Purpose: The prognosis of colorectal carcinoma (CRC) with liver metastasis varies from case to case. A standardized classification system for evaluation of the prognosis and the treatment is needed. Therefore, we developed a new staging system for CRC with liver metastasis (HM-stage) based on the survival data. Patients and Methods: We evaluated 148 CRC patients with liver metastasis treated between 1985 and 1999. Prognostic factors were identified based on a multivariate analysis. According to the final prognostic factors and hazard ratios, we defined the HM- stage. Results: Three factors, including extent of liver metastasis, depth of tumor invasion and peritoneal metastasis, were identified to be the final prognostic factors. These factors were then assigned points. The patients were classified as being HM-stage I to IV by the sum total. The median survival time for each HM-stage were 37 months for HM-stage I, 23 months for II, 10 months for III and 7 months for IV, respectively. A significant difference among each stage was recognized (p<0.0001). Conclusion: This new staging system for CRC with liver metastasis is simple and should be clinically useful for both estimation of the prognosis and evaluation of the therapy in patients.