Impact of expanding criteria for resectability of colorectal liver metastases: An application of Chinese Guidelines for the Diagnosis and Comprehensive Treatment of Hepatic Metastasis of Colorectal Cancer (Version 2010)        ZHONG Yun-shi*, ZHU De-xiang, WEI Ye, et al. *Department of General Surgery, Zhongshan Hospital, Institute of General Surgery, Fudan University, Shanghai 200032, China
Corresponding author：XU Jian-min, E-mail：xujmin@aliyun.com
Abstract    Objective    To ascertain the short-term and long-term outcomes of expanding criteria for resectability of colorectal liver metastases (CRLM) from Chinese Guidelines for the Diagnosis and Comprehensive Treatment of Hepatic Metastasis of Colorectal Cancer (Version 2010). Methods    The data of 530 consecutive CRLM patients underwent hepatectomy between 2000 and 2010 in Zhongshan Hospital of Fudan University were analyzed retrospectively. Patients were divided into two groups according to different resectability criterias (group I: 2000-2004; group II: 2005-2010). Mortality, morbidity and survival rates were evaluated. Results    After the expansion of resectability criteria, hepatectomy rate increased from 25.1% to 35.1% (P<0.05). Patients in group II presented with higher preoperative serum CEA and CA19-9 levels. Although perioperative mortality (2.2% in group I and 0.9% in group II) and morbidity (20.9% in group I and 29.8% in group II) were observed with no significant difference between two groups. But there was a trend toward a higher morbidity was observed in group II. In addition, there was no significant difference in recurrence  rate (27.5% in group I and 36.7% in group II) or overall survival (43.7 months in group I and 55.7 months in group II; 5-year survival, 43% and 49%). Conclusion    The favorable short-term and long-term outcomes justify an expansion of the criteria for respectability in Chinese Guidelines for the Diagnosis and Comprehensive Treatment of Hepatic Metastasis of Colorectal Cancer (Version 2010).