Model of Iwatsuki et al for a Patient with Metastatic Colorectal Adenocarcinoma Undergoing Hepatic Resection (Pittsburgh Grades)

Risk factors for poor survival (overall and tumor-specific):

(1) surgical margins of the resected hepatic tumors positive for tumor

(2) extrahepatic metastases (including lymph nodes)

(3) >= 3 metastatic foci in the liver

(4) <= 30 months between colorectal tumor resection and hepatic resection

(5) metastases in left and right lobes of the liver (bilobar distribution)

Predictors of tumor recurrence:

(1) tumor size > 8.0 cm

(2) >= 3 metastatic foci in the liver

(3) <= 30 months between colorectal tumor resection and hepatic resection

(4) metastases in left and right lobes of the liver (bilobar distribution)

where:

• The handling of positive surgical margins and extrahepatic metastases when only one of the 2 findings in Grade 6 are present.

The 5 year overall survival ranges from 57% for Grade 1 to 4% for Grade 6.